[rubys-delusions]

this is an anonymous sideblog. while i am very active, i dont post very often

[cluster-a-pds]

awhile ago i read that if someone is schizoid/schizotypal then they can't be schizophrenic. i've seen some people refer to those personality disorders as "the beginning of schizophrenia" yet i highly doubt that that is true. would the flattening effect in schizophrenia be considered schizoid traits or something? if i remember correctly, those two pds are on the schizophrenic spectrum. is it possible for someone to be both schizophrenic and schizoid/schizotypal?

Hey, thanks for the question!! 

I wouldn’t really consider them the beginning of Schizophrenia. Though some people with these disorders will go on to develop Schizophrenia, that’s not an absolute must, and many will never go on to develop it.  And yeah, they are on the Schizophrenia spectrum, so there’s definitely similarities between both disorders and different symptoms of Schizophrenia.

But no, it doesn’t seem like they would usually be diagnosed together, though it is possible. In both of the criteria it says that neither should be diagnosed if they occur exclusively during the course of Schizophrenia. It seems like in most cases it probably wouldn’t be necessary to diagnose both, like if someone with diagnosable Schizophrenia also had Schizotypal traits, they probably wouldn’t need to be diagnosed with both since those traits could just be attributed to the Schizophrenia. It seems like mostly they could be ruled out or something.

But  (As shown below. I only screen-capped the one for StPD,  but it says the same thing in the differential diagnosis section for both StPD and SzPD) 

 they still technically can both be diagnosed, but the PD symptoms have to have been present before the onset of Schizophrenia and still persist when symptoms are in remission. So they are probably both diagnosed occasionally. I’m not sure exactly how common this is though. Most things I find just say stuff like this (taken from here)  :

So I mean it makes it seem like it doesn’t happen very often but it’s also not technically impossible so I guess it just depends on the person diagnosing you. I am led to believe that it’s not incredibly common though.  

Anyways, I hope that is enough to answer your question! Have a great day, anon! - Luca

[sickiehugs]

Hi so this is a bit different from my usual content, but I figured more people will see it here than if I were to say it on my main since I rarely do anything there.

If you ever feel like your friends secretly hate you, or are scared of you, or are upset with you but aren't telling you, and you have absolutely no proof to back it up,

Keep a happy folder.

Here are some things you can fill it with:

Screenshots of times your friends have said good things to/about you

.txt files where you write down different times your friends have done good things for you

Photos from spending time with your friends

Photos or .txt about your friends celebrating your birthday

Photos of presents you've gotten from your friends

Whenever you have those unjustified fears, look in your folder and remind yourself that they care.

[thebrainguys]

My personal useful links on Cluster A PDs

This is just a long post where I can post useful stuff I've found in one place. Oriented more towards ppd but there's a lot of general cluster A stuff here too. Will be updated whenever I find something I want to add.

Tumblr posts are admittedly not the end all be all of information but most of these are cited

Schizotaxic model

Splitting in different disorders (bpd vs npd vs szpd)

PPD subtypes and other pd subtypes (tumblr vers)

SzPD vs Autism (Highlighted symptoms are either SzPD exclusive or have different root causes than autism) - unsure of source

[malkavianne]

Cluster A Personality Disorders

LINK 1, 2, 3, 4

Personality disorders are characterized by four criteria:

1. Distorted thinking patterns: People with PDs have distorted thought patterns about themselves and the world around them. These extreme and strange ways of thinking are generally most evident when interacting with non-disordered personalities. Distorted thinking can often be sorted into five categories:

Black-and-white thinking: For the person, everything is all-or-nothing. They either always get their way, or never. In an argument, the person is absolutely right and the other person is absolutely wrong, there is no room for nuance or both parties to be correct/incorrect.

Idealization and devaluation: Similar to black and white thinking, the person fluctuates between seeing others as flawless and perfect, or hopelessly incompetent and flawed, even malicious or evil. These fluctuations can be triggered by even minor-seeming events.

Suspiciousness and distrust: The person has a heightened sense of suspicion of others. They may believe that humans are inherently manipulative or harmful, and constantly search for these motives in others’ actions. For example, a small gift may seem to them like an act of manipulation or bribery.

Odd and unusual beliefs: The person believes in strange things, contrary to the person’s culture. 

Perceptual distortions: The person experiences brief “glitches,” such as hearing their name called in an empty building or seeing another’s face change before their eyes. These distortions are not considered hallucinations or delusions because the sufferer can often distinguish them from reality.

2. Problematic emotional responses: People with PDs often have emotional reactions, contrary to their culture, that are either too modulated or too exteme. For example, people with schizoid PD are very over-regulated and consequently cold and indifferent, while people with histrionic PD are very under-regulated and thus prone to extreme mood swings and reactions.

3. Over/under-regulated impulse control: Similar to the above, people with PDs are either over- or under- constrained in controlling impulses. For example, people with avoidant and obsessive-compulsive PD are over-regulated and consequently extremely controlling over their environment, while people with antisocial or borderline PD are under-regulated and prone to risky, reckless behavior.

4. Interpersonal difficulties: As a result of the above characteristics, a person with a PD often experiences considerable difficulty in relationships of all types. For example, a person with borderline PD may often frustrate their partner by starting arguments, acting on their distorted thoughts and under-controlling their impulses.

Cluster A: The Odd, Eccentric

Cluster A disorders are characterized by social awkwardness and withdrawal. Disorders within the same cluster have a high comorbidity; if you have one PD, it is very likely that you have some symptoms, or even another fully-developed PD from the same group. Note that these symptoms are not checklists; every case is unique and not everyone will experience the same symptoms.

SCHIZOID: 

Primary features: detachment, flat affect, disconnection

From within

Little to no social drive, urges.

Does not develop attachment; it’s debated whether this is an inability or a choice not to, most likely varies with the individual 

Emotions are shallower, more fleeting - default state is virtually emotionlessness

May have trouble identifying emotions and/or putting them into words

Apathetic, listless, detached

Anhedonia (lit. lack of pleasure) , avolition (lit. lack of want, desire)

Lacks affective empathy, the ability to “walk a mile in one’s shoes” and feel as someone else does. However, most schizoid people still posses cognitive empathy, or the ability to recognize, categorize, and name emotions in others.

Indifferent towards praise and criticism

May have a rich, detailed inner world OR be somewhat unimaginative, prefer mechanical and scientific pursuits [citation needed - contributions welcome]

From without

Overt schizoids do not disguise their personality and often appear cold, aloof, indifferent, callous, dull, uninterested, boring. Often speaks tersely and/or in a monotone.

Covert or “secret schizoids” present themselves through a persona that is sociable, friendly, and engaged. 

Few/no friends or confidants - if any, they’re probably first-degree relatives

Seem listless, directionless, without goals

May avoid things like seeking a job or higher education due to avolition, a desire to avoid engaging with society

Will probably not seek out professional help on their own or for being schizoid per se - most see a psychologist only at the urgings of a family member and for an unrelated illness, such as depression 

Due to these factors, SzPD appears to be among the rarest PDs but is probably underdiagnosed

SCHIZOTYPAL:

Primary features: odd beliefs, unusual thought patterns/speech, social discomfort

From within

Holds suspiciousness and paranoid ideations about other people or the human species in general, especially based on fears of physical/verbal/sexual violence - contrast to social anxiety, which is based on fears of embarrassment and misreading social cues

Feels acute discomfort in social situations and interpersonal relationships that does not diminish with familiarity - usually due to paranoid ideations, but a certain level of / comorbidity with social anxiety is not uncommon

Experiences minor cognitive and perceptual distortions such as movement in the corner of the eye, a sensation of weightlessness/melting limbs, hearing their called name in a crowd - as stated in the introduction, these are generally not considered to be delusions or hallucinations.

Experiences magical thinking, or the belief that their thoughts influence reality - a development of Obsessive-Compulsive Disorder may result, as the schizotypal person struggles to control certain malicious or frightening thoughts and develops rituals to pacify or neutralize them

Experiences ideas of reference; believes that other people notice them, notes passing events (ex. a popular advertisement) as having a hidden message or meaning

Holds odd beliefs and superstition (that are unusual for the patient’s culture and upbringing) . An American example would be a person that believes they can read minds, that their thoughts are being stolen, or that they are targeted for alien abductions. 

May experience psychotic episodes (e.g delusions, hallucinations) when under extreme duress - frequent, non-stress related psychosis is indicative that the schizotypal person has progressed to schizophrenia.

From without

Dresses oddly and inappropriately; may be mismatched, ill-fitting, dirty, or inappropriate for the occasion/setting

Odd thinking and speech patterns - may be overly abstract, metaphorical, vague, elaborate, ornate, or focus on the “wrong things” in conveying a message - schizotypal people can be hard to understand or follow in a conversation 

Inappropriate or flat affect, an inability to express conventional emotions or depths thereof

PARANOID:

Primary features: pervasive distrust and suspiciousness

Paranoid Personality Disorder is generally not diagnosed if the person has already been diagnosed with a psychotic disorder, such as schizophrenia.

From within

Strong, constant assumption that others are out to hurt, manipulate, and/or humiliate them

Puts tremendous effort in maintaining safety, distance

Tends to ruminate over past slights

Tends to hold grudges, jealousy, envy - includes romantic/erotic jealousy and suspicions of infidelity

Constantly worries over and/or questions the loyalty of others

Reluctance to confide in others - fears that the confidant may use that information against the paranoid person

Constantly searching for malicious intent in others - to the paranoid person, a simple apology can be an attempt to re-earn their trust and manipulate/hurt them again and again in the long run

Emotional state dominated by suspicion, distrust, and hostility

Hypervigilant

Places importance on self-reliance, autonomy

From without

May pre-emptively attack someone they feel threatened by

Expresses psychic distress through: complaining/criticism, argumentativeness, aloofness, stubbornness, sarcasm, a desire to control their environment

Keeps self guarded, secretive - may appear devious, cold, callous, even cruel

Combative and suspicious nature provokes others  ► reinforces the original belief that other people are out to hurt them ► becomes more combative and suspicious, provoking others ► reinforces the original belief… and so on and so on, creating a feedback loop of hostility

[bellwitchfaggot]

Being schizophrenic but trained to hide your negative symptoms is just like. Sometimes u r tired and u forget to be a Not Schizo Person and everyone in ur life thinks ur upset about something but actually u just dont have the energy to perform normal affect/speech/social and cognitive input

[schizodiaries]

list of cognitive distortions

Cognitive distortions are biased and negative thinking patterns not based on fact or reality. They impact how we see ourselves/others and are usually associated with depression, anxiety, or trauma. (Note: this list was given to me by my therapist and is not my original writing.)

All-or-nothing thinking — You see things in black-and-white categories. If your performance falls short of perfect, you see yourself as a total failure.

Overgeneralization — You see a single negative event as a never-ending pattern of defeat.

Mental filter — You pick out a single negative detail and dwell on it exclusively so that your vision of all reality becomes darkened, like the drop of ink that discolors the entire beaker of water.

Disqualifying the positive — You reject positive experiences by insisting they “don’t count” for some reason or other. In this way you can maintain a negative belief that is contradicted by your everyday experiences.

Jumping to conclusions — You make a negative interpretation even though there are no definite facts that convincingly support your conclusion. A) Mind reading: You arbitrarily conclude that someone is reacting negatively to you, and you don’t bother to check this out. B) Fortune telling: You anticipate that things will turn out badly, and you feel convinced that your prediction is an already-established fact.

Magnification (catastrophizing) or minimization — You exaggerate the importance of things (such as a goof-up or someone else’s achievement), or you inappropriately shrink things until they appear tiny (your own desirable qualities or other people’s imperfections). This is also called the “binocular trick.”

Emotional reasoning — You assume that your negative emotions necessarily reflect the way things really are. “I feel it, therefore it must be true.”

Should statements — You try to motivate yourself with should and shouldn’t, as if you had to be whipped and punished before you could be expected to do anything. “Musts” and “oughts” are also offenders. The emotional consequences are guilt. When you direct “should” statements towards others, you feel anger, frustration, and resentment.

Labeling and mislabeling — This is an extreme form of overgeneralization. Instead of describing your error, you attach a negative label to yourself. “I’m a loser.” When someone else’s behavior rubs you the wrong way, you attach a negative label to them. Mislabeling involved describing an event with language that is emotionally loaded.

Personalization — You see yourself as the cause of some negative external event, which in fact you were not primarily responsible for.

[starschizo]

one aspect of schizophrenia i dont see talked about very much is one that is, in my experience, the most personally upsetting. and thats the breakdown of word articulation. as i write this i'm havign trouble even putting words to describe how its hard to put words.

i used to be a prolific (fanfiction) writer. i can barely formulate tumblr posts at this point. it's not even that i was a particularly good writer, but it came so easily to me to put words on paper. i've always been a little bad at talking out loud due to my autism, but that used to be much better too.

it's just genuinely upsetting to me. i would trade my medication out in a heartbeat if there was one that treated this instead of my positive symptoms, my ability to pass as 'normal' be damned.

[thehauntedmask]

Reading these StPD snippets (x) and finding interesting things.

"The differential diagnosis for schizotypal personality disorder includes schizophrenia and several personality disorders. Paranoid and schizoid personality disorders share many of the core features of schizotypal personality disorder, but differ by degree or absence of eccentricity. Borderline personality disorder shares some of the unusual speech and perceptual style, but it demonstrates stronger affect and connection to others. Patients with avoidant personality disorder, while uncomfortable and inept in social settings, are not eccentric and crave contact with others. Schizophrenia differs from schizotypal personality disorder in that the schizotype possesses good reality testing and lacks psychosis."

"Treatment of persons with STPD should be cognitive, behavioral, supportive, and/or pharmacologic, as they will often find the intimacy and emotionality of reflective, exploratory psychotherapy to be too stressful (Kwapil and Barrantes-Vidal, 2012). Practical advice and social skills training are usually helpful and often necessary, as their social decision-making may itself be problematic."

"Like the person with a borderline personality, the individual with a schizotypal personality seems to lack a core. This person also is stalked by a rather unsettling sensation that he or she is somehow empty. This blandness becomes an invitation to an in-pouring of vivid fantasy and psychotic-like process. The world becomes peopled with clairvoyant messages, ghost-like presences, magical hunches, and secretive glances. Like a child withdrawn into a world peopled with pretend playmates, the person with a schizotypal personality silently retreats from life. Unlike a person with a schizoid personality described earlier, a person struggling with a schizotypal personality disorder is frequently sensitive to rejection. This person wants contact but does not know how to make it."

"Regarding language, there are unclear, strange, or stereotyped expressions and incorrect use of words, though not to the point of associative loosening and incoherence."

"Patients with schizotypal personality disorder also can appear aloof, apprehensive, and suspicious. They may be hypersensitive or hostile if they are distressed. However, they generally appear interpersonally inhibited. These patients show evidence of cognitive distortions, for example, nondelusional ideas of reference. They show a lack of social skills and are not able to accurately perceive social discourse... As with schizoid personality disorder patients, these patients are difficult to engage, and one must attend to appropriate boundaries and interpersonal distance. Their odd speech and behavior may be off-putting, and you may need to monitor your own responses to such behavior. However, once these patients are engaged, they tend to form a strong dependent relationship with their clinician."

[221bluescarf]

Anhedonia

an·he·do·ni·a (noun) The inability to feel pleasure.

"Many everyday acts are likely performed because of their intrinsically reinforcing consequences. Recent research has suggested that different types of anhedonia may be operative in schizophrenia and major depression." —World Psychiatry

In major depression, the modal phenomenon seems to be the reduced ability to experience pleasure after engaging in potentially pleasant acts (consummatory anhedonia).

In schizophrenia, there seems to be preserved ability to experience pleasure, while deficits in the ability to anticipate pleasureable consequences (anticipatory anhedonia) apparently predominate. In anticipatory anhedonia, the positive consequences of previously performed behavior are difficult to recall and the motivation to repeat these acts is therefore reduced.

[...] Individuals with persistent cognitive deficits such as those seen in schizophrenia may also be unable to volitionally retrieve their memories of previous positive experiences, leading to an increase in the inability to anticipate the pleasurable consequences of every action

Disability is pervasive in schizophrenia and is refractory to current medication treatments. Inability to function in everyday settings is r

(photo credit)

[bpdarlingx]

Chronic $/h addixtion

If you're starting out s/h please get help before it becomes a full blown addiction. I started at 12 and now at 21 I have permanent nerve damage in both arms that makes writing and holding utensils hard. I have hit several veins nearly bleeding out and needed blood transfusions. I've had countless trips to the ER for stitches and staples where you get treated like a criminal for needing medical resources.

I literally scare children if I wear short sleeves or shorts and look like I've been thrown through a window due to the severity of my scars.

I will never be able to wear short sleeves comfortably ever again. My scars are raised, purple/red and thick years after when I caused them; they are visible through tight clothing and unless I get expensive laser to flatten them I'm stuck with them for life ://

[mayonaise2011remaster]

I wish people talked more about the permanent damage s3/f h@rm can do. I have been engaging in $h for 15 years now and I have muscle damage in my legs from when I was in middle school and just not being careful. now I sometimes have to use mobility aids to get around. My scars from a decade ago still are raised and purple, I have almost no feeling in my wrists, my circulation is so shit from all the damage I did to my veins. I'm always itchy when it's hot because scars do not leave room for ways to sweat, so it causes you to be so itchy you feel like you're dying. people stare and point and ask me questions. or just straight up say the most out of pocket shit. and I know the scars can be gratifying, but when they start to cause every day problems, they end up not being as fun as they used to.

I've been to inpatients, outpatient programs, residential programs, everything. But I let it go for so long that I don't know if I'll ever fully recover. I wish I got help when I started. I wish I had the money to get help now, but I don't think I can ever afford anything more than a therapist once a week.

I totally understand that it's hard to stop, and some people aren't in a place to stop. but make sure you are at least educating yourself on how to do the most minimal damage possible. know where your veins and ESPECIALLY arteries are. know what to do for each "type" (babys, stryos, beans, taffy, and god forbid, bone) and how to clean yourself up, patch yourself up, and avoid infection. make sure you have a tetanus shot. please, please, be safe. and when you start to feel, even a little, that this is not what you want, get help immediately. your first thought of "maybe this was a mistake" or "this is feeling like too much" or "I regret last night" or anything like that, get help immediately. you really don't want to be stuck with this as an adult.

most of my friends who I knew ten years ago who were on here are gone. they didn't get the help they needed, they weren't educated and informed and safe, or they chose a different way out because they felt like they couldn't get help. and I'm stuck in this perpetual loop because I don't know anything different. I started at 7 and now I'm 22, and I know nothing else but this. and it's so lonely

[wolveshowlingatnight]

Treatment of Schizoid Personality by Zachary Wheeler

I’m either at one or two extremes.

“I’m not interested in friendship with others. I care more about my freedom. Other people are intrusive and overwhelming and I lose a part of myself each time I get into a friendship or relationship of any kind. What would I need a friend for anyway? Fantasies are my substitute.”

Me during the rare time I get attached to someone (it’s only happened twice):

“I love you so much. I’m so attached to you I feel like I’m going to actually die if you abandon me. It feels like a bomb going off. It feels like the world is ending. I’m terrified, I can’t breathe, please don’t leave me. Stay close, but don’t get too close.“

[schizoidsuggestions]

could it be a schizoid thing to be capable of strong emotions but never show them to anyone? like i do cry, but i do so alone in my room and don't tell anyone about it afterward, as if it never happened

no lmao thats like … normal

[wolveshowlingatnight]

You can be capable of strong emotions and still be schizoid. SzPD is rarely as grim as the DSM makes it out to be. 

Overt –  Open and observable

Covert –  Hidden and concealed

The DSM and ICD criteria are the overt signs.

The PDM criteria are the covert signs.

Most schizoids match the both DSM and PDM criteria:

It is important to remember that however restricted they may outwardly appear, most schizoids are highly sensitive and show a heightened awareness to their own feelings. “Possibly because they are undefended against the nuances of their own more primal thoughts, feelings, and impulses, schizoid individuals can be remarkably attuned to unconscious processes in others. What is obvious to them is often invisible to less schizoid people” (McWilliams, 2006, p. 13). Still, for most schizoid people, the smallest surge of emotion feels like a bomb going off (Doidge, 2001).

Some schizoids have more severe symptoms and only match the DSM criteria. They don’t desire relationships, have little if any desire for sexual experiences, have anhedonia and avolition, and are not capable of strong emotions. They match the DSM to a T. The PDM does not apply to schizoids on the severe end:

As the severity of the schizoid pathology increases, the patient is likely to show deficits in his social skills and increasingly constricted or absent emotional experience. At the same time, the more acute cases show increasing or total denial of dependency needs and seem to have little need for human closeness.

Schizoids who have strong emotion, who are highly sensitive, long for closeness, have affects so powerful they must suppress them, and fear love are still schizoids. 

Source

Treatment of Schizoid Personality: An Analytic Personal Handbook

A clinical dissertation submitted in partial satisfaction of the requirements for the degree of Doctor or Psychology.

by Zachary Wheeler, M.A 

[wolveshowlingatnight]

Symptoms of Schizoid Personality Disorder

The DSM isn’t accurate. That only represents schizoids on the severe end who have completely given up on relationships with people. Below are the symptoms from the Psychodynamic Diagnostic Manual (PDM) which is much more accurate. PDM Criteria for Schizoid Personality Disorder: 

Highly sensitive and shy – They may seem completely nonreactive, yet suffer an exquisite level of sensitivity. They may look affectively blunted while internally coping with what one of my schizoid friends calls “protoaffect,” the experience of being frighteningly overpowered by intense emotion (McWilliams 2006).

Easily overstimulated – As a result of the impingement, the schizoid child’s immature ego functions are overwhelmed, his capacity to be alone fails to develop, and he is chronically overstimulated (Guntrip 1969).

Fear of closeness/Longing for closeness –  The central conflict of the schizoid is between his immense longing for relationship and his deep fear and avoidance of relationships (PDM Task Force, 2006). As Akhtar (1987) notes, while the schizoid is outwardly withdrawn, aloof, having few close friends, impervious to others’ emotions, and afraid of intimacy, secretly he is exquisitely sensitive, deeply curious about others, hungry for love, envious of others’ spontaneity, and intensely needy of involvement with others.

Splitting (In-and-Out Program) –  When in relationships, the schizoid maintains a pattern of oscillating towards and away from intimacy, alternatively desiring, and being excited at the chance for contact, and becoming claustrophobic, smothered, choked, imprisoned and terrified of being devoured or smothered by the other. The schizoid then must break free and recover independence (Guntrip, 1969).

General emotional pain when overstimulated, affects so powerful they feel they must suppress them – for most schizoid people, the smallest surge of emotion feels like a bomb going off. Fearful that any feeling can quickly become overwhelming, the schizoid denies and isolates all his feelings so that this does not occur (Doidge 2001).

The view that dependency and love are dangerous –  Schizoids come to believe that it is their love, rather than their anger, that is destructive, dangerous, and best kept out of sight (Fairbairn, 1940).

The belief that the social world is impinging and dangerously engulfing – When a loss of self occurs, the schizoid becomes estranged from his needs and feelings and is unable to be assertive, even in relatively harmless situations he fears that he is vulnerable to being controlled, appropriated, or taken over by another person. Laing (1960) describes the subjective experience of engulfment to being buried alive, being drowned, being caught in quicksand, losing one’s self, being absorbed by another person, being placed under unsolicited obligation, enclosed, swallowed up, eaten up, suffocated, smothered, and stifled.

Withdrawal, both physically and into fantasy and indiocyncratic preoccupations – The schizoid’s tendency for withdrawal and preoccupation are noted as primary defensive functions. Withdrawal is a process that has both physical and emotional components. Identifying the signs of withdrawal requires attention to body language, the quality and quantity of communication, and the emotional experience of the patient. Physical withdrawal is associated with closed body language, limited eye contact, slumped or shrinking posture, and the orienting of the body away from others. The withdrawn individual seeks to create distance between the self from others, be it moving back a few steps, moving to the perimeter of the room, or becoming reclusive and cloistered within the home. Physical activity reduces often to the point of inactivity, and the person may report feeling weak, tired, sleepy, or exhausted. The emotional experience of withdrawal often includes an increase in fantasy life, feeling boredom or apathy, or  even disgust, revulsion and aversion. The emotional state of the withdrawn self is passive, disconnected and lacking the energy to make emotional contact, which over time leads to depersonalization and emptiness.

Schizoids are far from indifferent and unemotional.

Source

[wolveshowlingatnight]

Schizoid Automatic Thoughts

It is important for me to be free and independent of others.

I enjoy doing things more by myself than with other people.

In many situations, I am better off to be left alone.

It’s better to be alone than to feel “stuck” with other people.

I can use other people for my own purposes as long as I don’t get involved.

I am a social misfit.

Intimate relations with other people are not important to me.

My privacy is much more important to me than closeness with people.

Relationships are messy and interfere with freedom.

Life is less complicated without other people.

It is better for me to keep my distance and maintain a low profile.

I shouldn’t confide in others.

It doesn’t matter what people think of me.

I am not influenced by others in what I decide to do.

I set my own standards and goals for myself.

What other people think doesn’t matter to me.

I can manage things on my own without anybody’s help.

I’d rather do it myself.

I prefer to be alone.

I have no motivation.

I’m just going through the motions.

Why bother?

Who cares?

[mentalhealthmartini]

But doesn’t literally everyone think like this? What makes any of these schizoid specific?

[wolveshowlingatnight]

 A personality disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.

For schizoids, all of these automatic thoughts cause some kind of distress or impairment. And on top of that, there is a much deeper meaning underneath all of these statements, I’ll explain below.

These are the classic, overt (open and observable) symptoms for SzPD:

These are the covert (hidden and concealed) symptoms of SzPD:

I posted more detail about the difference between these two types of schizoids in another post. 

The overt, DSM criteria alone causes impairment for schizoids. That is, unless they put on the “mask.” The mask is essentially just looking normal on the outside. This takes effort and usually leaves schizoids exhausted at the end of the day for having to put up a false self. For the schizoids who don’t have a mask (or do, but are too tired to uphold it that day), they appear “odd and eccentric.” They usually display poor social skills and a flat affect. These cause the schizoid to appear awkward and emotionally cold. This can cause impairment in social functioning and work functioning. Their outer symptoms (some schizoids can’t uphold a mask even if they try, it’s hard to do) cause them to fail job interviews, get fired, not get promoted as often as non-schizoids, and cause them to have trouble socially. If they go to college, they are more likely to have trouble with group projects and having a roommate. Below is an image depicting what SzPD generally looks like on the outside (overt) vs what they feel on the inside (covert):

The PDM criteria are the covert symptoms that cause internal distress. Most schizoids match the PDM criteria too. Only in the more severe cases are schizoids impacted enough to where they don’t match most (or any) of the PDM criteria and have zero longing for other people and don’t experience extreme emotions. Most schizoids are highly sensitive, shy, easily overstimulated, fear and long for closeness, emotional pain so strong they must suppress it, and they withdraw into fantasy when needing to seek refuge. That withdrawal to fantasy can be a form of dissociation since they are attempting to detach from their self and environment.

As the severity of the schizoid pathology increases, the patient is likely to show deficits in his social skills and increasingly constricted or absent emotional experience. At the same time, the more acute cases show increasing or total denial of dependency needs and seem to have little need for human closeness.

Schizoids also show borderline level defenses.

For the most part, schizoid patients rely on primitive borderline defenses over neurotic or mature defenses (Giovacchini, 1979). Patients who rely on primitive defenses often have difficulty with reality testing and show impaired ability to interact in the world. These defenses, as listed in Figure 6.3 below, include splitting, extreme projection, primitive denial, devaluation and idealization, projective identification, and omnipotent control (Clarkin et al., 2006). In general, however, the most common of these observed in schizoid patients are splitting, denial of feelings, devaluation of objects, and idealization (Kahn, 1974).

The most common defenses being splitting, denial of feelings, devaluation of objects, and idealization can cause significant impairment and distress. Also schizoids generally avoid relationships due to fear of love being dangerous.

Fairbairn (1940) famously noted the schizoid’s fundamental belief that it is his love, rather than his hate, that destroys relationships. Fearing that his needs will weaken and exhaust the other, the schizoid disowns these needs and moves to satisfy the needs of the other instead. The net result is a loss of ego within any relationship he enters, eventually kicking off an existential panic. Since love becomes equated with unsolicited obligation, persecution, and engulfment, the schizoid defaults to self objects instead, consuming himself with love to avoid being consumed by the love of the other (Laing, 1960). As Appel (1974) notes, “From these fears derive the negativism, stubbornness, and reluctance of the schizoid to love. Since he equates love with fusion, control, and persecution, the schizoid must hate what he loves—the classic ambivalent position”.

Aside from the borderline level defenses when schizoids are in relationships, they also have an approach-avoidance conflict:

When in relationships, the schizoid maintains a pattern of oscillating towards and away from intimacy, alternatively desiring, and being excited at the chance for contact, and becoming claustrophobic, smothered, choked, imprisoned and terrified of being devoured or smothered by the other. The schizoid then must break free and recover independence (Guntrip, 1969). The oscillation in and out of relationships is the real world enactment of these conflicts around involvement. The schizoid’s legendary avoidance of relationships reflects his assessment that abandonment of others is a lesser evil than facing engulfment and loss of self, despite his longing for relationships (McWilliams, 2004; Seinfeld, 1991).

The schizoid alternates between fearing abandonment and encouraging it. Borderline level defenses and approach-avoidance behaviors cause social impairment.

So there are deeper reasons for the automatic thoughts schizoids have. Especially the statement, “It is important for me to be free and independent of others.” The word free implies the schizoid is avoiding something. They avoid obligation, persecution, engulfment, and fear of abandonment (fear of wearing out and exhausting the other person), so they believe it is better to be independent of others so that they can remain free. Underneath all the automatic thoughts are a deeper, depressing undertone full of fear and despair. Any time a schizoid says, “I prefer to be left alone and am disinterested in relationships with other people” they are really saying, “I prefer to be left alone and am disinterested in relationships with other people because I would rather be alone than be engulfed and obligated to another person.”

I’m schizoid and my deeper reasons for avoiding relationships is due to that fear of engulfment and not wanting any obligations towards other people. I don’t want to be obligated to spend time with others. I don’t want to be obligated to provide emotional support or care about their success. I don’t have to be on anyone else’s schedule and I don’t have to revolve my life around someone else. I can do whatever I want, when I want. I can leave the house and not have to tell anyone where I’m going. If I arrive home later than usual, I don’t have to explain to anyone where I was. I associate relationships with a loss of freedom. And that fear of loss of freedom causes me to have a genuine disinterest in relationships with others. I don’t match the PDM criteria for “longing for others” because I’m so deep into my avoidance of losing my independence that I lost interest in others a while ago. To me, other people = loss of freedom. And I don’t see why that would interest me. I don’t see people as confidants, I see them as oppressors. As long as other people are in my life, I’m obligated to give them my time, self disclosure, and in turn become controlled and engulfed. Being with other people feels like I’m being absorbed and swallowed up. Like I’m losing myself.

Non-schizoid people don’t associate other people with a loss of freedom. They intentionally seek out relationships with others because they enjoy friendships and relationships. Non-schizoids enjoy being with people, they aren’t filled with distress and dread at losing their freedom. In fact, they don’t even consider that their freedom is being stolen anyway, since they don’t view friendships and relationships as loss. They view it as a gain.

There is a dark undertone to the things schizoids say and believe. It isn’t always how it appears on the surface. It’s a distressing disorder full of impairment in mental and social functioning.

Source

Treatment of Schizoid Personality: An Analytic Personal Handbook

A clinical dissertation submitted in partial satisfaction of the requirements for the degree of Doctor or Psychology.

by Zachary Wheeler, M.A

[mentalhealthmartini]

Thank you for such a thorough response. It was both interesting and disturbing to read because it reflects me so eerily, and I was complaining about these EXACT issues in therapy last week, completely unaware of this stuff. I wondered in the past if I was schizoid, but after looking at the DSM and ICD criteria (didn’t know about PDM), dismissed myself, especially since I’ve already been diagnosed with BPD and figured they were incompatible (interestingly though, my psychiatrist identified me as the “quiet” type as opposed to the “classic” presentation, so all my garbage is internalized). Since personality disorders affect (two or more of, according to the DSM-V) cognition, affectivity, interpersonal functioning, and impulse control, it’s not totally wild to think that quiet borderline and covert schizoid could affect different (or in some cases the same) areas of life and exist at the same time. While it may appear contradictory, nowhere does it say that they’re mutually exclusive.

Reading this made me realize how similar the two disorders are, and that perhaps I shouldn’t dismiss my suspicions, especially since the schizoid part of the equation (I mean, I’m assuming it’s schizoid as it’s not better explained by BPD and I thought this was just “me being me” but apparently not lol, though I should ask a professional to confirm) has been causing me more distress in terms of interpersonal relationships and attitudes towards relationships. I ended up reading through the entirety of that handbook, as well as exploring The Core Sensitivities: A clinical evolution of Masterson’s Disorders of Self by Brooke E. Poulsen and Joseph J. Coyne [article here], which compares attachment styles of schizoid vs borderline vs narcissist. 

@actuallyschizoid replied with:

Um… nope? ^^ It was surprising to me at some point as well, but in fact the vast majority of people think direct opposite. They actually *want* other people near them, they want others to need them and want to have people they need around to feel good. They like to get help from others, they enjoy getting gifts or some signs of attention from people they like. No, really, they do. It’s considered normal to depend on people near you. Not wanting that is the thing that makes schizoid look weird (among other things), despite how obviously natural it is for us to think this way.

The idea of enjoying help from others or depending on people is something I definitely Don’t Like and makes me Deeply Uncomfortable. I guess I thought everyone felt claustrophobic or in pain around others. 

This is interesting to me because I fit both the BPD and SPD attachment “styles” (which again, seems contradictory), and seemingly either cycle between the two or they occur at the same time. That is, I act/think like a schizoid (according to the literature presented to me anyway) when I’m not engaging with people/this is my attitude towards people, but if I get close to someone, I end up with the typical BPD chaos. A lot of the BPD chaos happens internally and is rarely vocalized (quiet borderline, remember). I wonder if there’s some kind of “schizoid expression stifling” going on or if that’s just me being introverted. Not all of me is pathological, but it’s hard to draw the line sometimes. What’s me just being funky vs psychiatric condition territory? Plus, the SPD/BPD distinction is hard to make as they can definitely reinforce each other because they can be very similar, like the intense schizoid emotions you mentioned which could easily be exacerbating the intense borderline emotions I experience.

It’s like I need people but I’m afraid of being around them. There’s the dilemma of “I can be myself” (too close, claustrophobic) or “I can be around them with a mask” (too impersonal to be meaningful or fulfilling). I experience intense abandonment anxiety as well as feeling the panic of losing my ability to be independent. I feel less lonely as well as disgusted by myself. (The handbook is interesting because I can’t relate to the AVPD attachment problems. It’s like I go schizoid and then jump over avoidant and straight into borderline and vice-versa, if that makes sense. Page 28 and 33 explain my attitudes/feelings well.)

I like being alone because being alone feels safe. As you said, there’s also no obligation to others, there’s freedom in being independent. So far, my most stable relationships and ones I don’t feel like I have an obligation to have been my best friend (who I see in person roughly twice a year, it’s all daily but exclusively via text), my therapist (it’s a one-way street: I don’t have to take into consideration her personal life or her feelings), and my sibling (can’t “leave” me unlike other people). I’ve been alone for a long time now. I can’t get hurt that way.

But at the same time, if I stay alone for too long, I transition from being genuinely happy in my self-imposed solitude to intense loneliness (something most online schizoids either don’t experience or don’t admit to feeling as I assume it can be a sign of “weakness”, but I guess this is part of the “schizoid dilemma” from page 102) to the point of feeling intensely suicidal or deeply afraid, like an “existential” loneliness. Or if I’m not lonely, I completely lose my shit and resort to self harm, overspending, going way too fast on the highway, and getting high all the time. A couple times I’ve had almost psychosis-like episodes observed in borderlines and according to this literature, schizoids. So I run to people out of desperation to alleviate the loneliness or to get away from myself, which often results in getting too close (or I anticipate that I’ll get too close, hello “real or imagined abandonment”!), and I get rid of them by burning bridges. Over and over again. Always too close, or not close enough. Like being by a fire and still being cold, but by the time I’m warming up, I’m too close and end up getting burned. That “sweet spot” is difficult to a) find and b) maintain. If you’re interested, check out Table 1 in the link I added (Core Sensitivities Prototype) and I basically fill out Separation Sensitive and Safety Sensitive simultaneously. It’s hard to explain. (I like tables and charts that summarize and boil everything down to the core basics, can you tell?)

And I haven’t even discussed the other schizoid-like aspects pertaining to my social awkwardness, inability to make eye contact with people I’m “closer” to, nor have I mentioned how the BPD aspects of my behaviour contribute to self-destruction in other areas of life. Or how this all relates to my screwed up eating and self-perception (while this blog is dedicated to me being batshit insane as a whole, it primarily focuses on my ED). This is all very dramatic and complicated and intertwined I tend to ignore it (and retreat to “calorie land” where all this emotional and social and life in general shit goes away so long as I focus on weight and calories). 

And that, kids, is how you dump intimate details onto a tumblr post!

Idk if any of this made a lick of sense and I know it was SUPER LONG and I don’t think anyone is reading this, but yay, online anonymous therapy with strangers. lol 

/rant over. thanks for coming to my TED talk.

[wolveshowlingatnight]

Reading this made me realize how similar the two disorders are

SzPD and BPD are so alike, I’m surprised they’re even different clusters.

Attachment Similarities:

Have issues with emotional regulation (feels like a bomb going off)

Have an intense fear of abandonment

Tend to idealize or devalue the self or others

“Push and Pull” Behaviors:

I notice that both personalities have a push and pull behavior. They alternate between pushing people away and pulling them as close as possible.

The schizoid push and pull is pushing people away and being distant when they feel they are being engulfed, controlled, swallowed up, absorbed, and intruded upon. They pull when they feel that they are being abandoned, rejected, exiled, or shunned. As soon as the schizoid feels intruded upon, such as being pressured by the other to self disclose as one example, they push. Because suddenly the schizoid is being controlled and intruded upon. And if they allow themselves to get too close, they feel terror at the thought of engulfment. But then once the person is kept at a distance, the thought of being abandoned and rejected comes back and then they pull the person in close just to be sure they won’t leave. The schizoid splits between feeling engulfed/controlled and feeling abandoned.

The borderline push and pull is pushing people away and being distant when they fear they are hated, abandoned, isolated, rejected, and feared. And they pull people closer when they feel they are loved, adored, and cherished. Because their worst fear is losing that love and adoration. But as soon as the slightest thing makes them feel abandoned, such as lack of response to a text or their loved one coming home late? The other person gets pushed as far away as possible because suddenly the borderline feels hated and abandoned. The borderline splits between feeling loved/adored and feeling hated/abandoned.

The splitting is a bit different, since schizoids and borderlines push people away for different reasons. Schizoids push people away when feeling engulfed, while borderlines push people away when feeling hated. Schizoids pull people closer when feeling abandoned, while borderlines push people away.

Schizoids push people away when feeling engulfed or controlled

Borderlines push people away when feeling hated or abandoned

Schizoids pull people closer when feeling abandoned

Borderlines pull people closer when feeling loved

The “Push” Behaviors are Different:

The reasons that other people are pushed away are entirely different. Schizoids push when there are signs of being engulfed or controlled. I don’t have any friends at the moment, but when I did, common things that would cause me to push people away were if I felt pressured to self disclose, was asked personal questions, was asked how I was feeling, or when I was invited to social activities. Getting pressured to reply to self disclosure, answer personal questions, or when I was asked about my feelings felt like an intrusion and violation of personal space. And getting asked to social activities felt like being obligated and losing my freedom, since I was suddenly on someone else’s schedule, not my own.

Borderlines push people away when they feel hated and abandoned, such as their friend or partner coming home too late, not texting back soon enough, or not giving the borderline as much attention as they require. The feeling of being hated makes them think they’re being abandoned, so it causes intense fear, which then causes the borderline to push the person away. Because you can’t be abandoned if you abandon the person first, right?

The “Pull” Behaviors are Different:

Schizoids tend to pull people back when they’re feeling abandoned, rather than pushing them away when feeling abandoned like the borderline does. The other person also cannot be the one to reach out first. This only makes the schizoid feel even more engulfed. Any attempts at the other person to make the schizoid feel loved are met with fear. The schizoid has to be the one to pull the other person in, at their own pace, in their own time frame.

The borderline tends to pull people back when feeling loved. The other person has to be the one to reach out first. Because in most cases, the borderline becomes so afraid of abandonment that they feel the need to be the one to abandon first. The other person has to give reassurance, tell the borderline that they’re loved, that they deserve that love, and that they won’t be left behind. Once the borderline is convinced they’re not being abandoned and that they are truly loved, they pull the person back in.

Overt Differences When Splitting:

The schizoid tends to express their pain inwardly. So on the outside, you almost always get that classic “aloof, cold, detached” appearance.

The borderline tends to express their pain outwardly. So on the outside, you almost always get that classic “dramatic, erratic” appearance.

These are just the most common overt differences, but sometimes they can be the opposite. Such as in the case of schizoids who express pain outwardly (only four of the seven symptoms in the DSM are required for a diagnosis of SzPD, so the “detached and cold appearance” is not required to be schizoid) or in the case of quiet borderlines.

I transition from being genuinely happy in my self-imposed solitude to intense loneliness (something most online schizoids either don’t experience or don’t admit to feeling as I assume it can be a sign of “weakness”,

In my case, I wasn’t even aware of my suppressed loneliness. Someone called me out on this on a different forum. I stated, “I never feel lonely, I’m perfectly fine! I stay in my fantasy life for hours. I’d rather do that than be around other people.” And he told me that the fantasy life is a replacement and substitute for real life interaction, and if I didn’t feel lonely on a subconscious level, I wouldn’t feel the need to even fantasize in the first place. So I was just suppressing it. I found that really profound.

And that, kids, is how you dump intimate details onto a tumblr post!

Good thing it’s all anonymous! I never self disclose in real life as I do online haha.

/rant over. thanks for coming to my TED talk.

You give an awesome TED Talk and I can relate to nearly everything you wrote. And it’s crazy how it seems that SzPD and BPD are two sides of the same coin. Both share the splitting, emotional regulation issues, and idealization and devaluation of self and others… But just different manifestations.

But wow my post is pretty long, I do way too much research and have way too much time on my hands.

[hauntedselves]

Personality Disorder Concepts: Defining Characteristics

These are the defining characteristics of PDs, each of which are different depending on the PD in question.

Triggering event(s).

The situations that trigger a maladaptive response that is reflected in the person’s behavioral, interpersonal, cognitive, and affective styles. Triggering events can be intrapersonal (e.g. failing an exam), or interpersonal (e.g. being criticised).

ASPD: Social standards and rules.

AVPD: Close relationships; being social/in public.

BPD: The expectation of meeting goals; maintaining close relationships; real or imagined abandonment.

DPD: The expectation that they can rely on themselves; being alone.

HPD: Relationships, particularly with those they’re attracted to.

NPD: Self-evaluation, either by themselves or others.

OCPD: Unstructured situations; meeting other’s standards (in all aspects of life: work, family, etc).

PPD: Close relationships; personal questions.

STPD: Close relationships.

SZPD: Close relationships.

Behavioral style

The way in which the person reacts to a triggering event.

ASPD: Impulsive, irritable, aggressive; irresponsible and struggles to keep commitments; relies on themselves, uses cunning and force; risk-taking and thrill-seeking.

AVPD: Tense and self-conscious; controlled speech & behaviour; appear apprehensive and awkward; self-criticising and overly humble.

BPD: Self-damaging behaviours (self-harm, self-sabotage, suicidal ideation); aggression; achieve less than they could (e.g. in work or school); chronic insomnia & irregular circadian rhythms (”body clocks”); feel helpless & empty void.

DPD: Docile, passive, non-assertive, insecure, and submissive; doubts themselves & lacks self-confidence.

HPD: Charming, dramatic, expressive; demanding, self-indulgent, inconsiderate; attention-seeking, mood swings, impulsive, unpredictable, and superficial.

NPD: Self-centred, egotistical, self-assured; dominates conversations; seeks approval and attention; impatient, arrogant, hypersensitive.

OCPD: Perfectionists; workaholics; dependable, stubborn, possessive; indecisive, prone to procrastination.

PPD: Always tense and hypervigilant; defensive, argumentative, guarded.

STPD: Eccentric, bizarre; strange speech; struggles with work and school and often become drifters and wanderers; avoids long-term commitment and looses touch with society’s expectations; dissociative.

SZPD: Lethargic, inattentive, eccentric; slow and monotone speech; rarely spontaneous; indifferent.

Interpersonal style

The way they relate to others.

ASPD: Deceitful; irritable, antagonistic and aggressive; disregards their and other’s safety; distrustful; lacks empathy; competitive.

AVPD: Sensitive to rejection; want acceptance but are too scared; withdraw and avoid when afraid; test people to see if they’re safe to interact with.

BPD: “Paradoxical instability”; splitting (idealise & cling vs devalue & dismiss); sensitive to rejection; “abandonment depression” & separation anxiety; superficial yet quickly developed and intense relationships; “extraordinarily intolerant” of being alone.

DPD: People-pleasers, self-sacrificing, clingy & needs reassurance; over-compliant & over-reliant on others; want others to be in control of their lives; avoids arguments; puts themselves down so they can receive the support of others; urgently seeks a new relationship when one ends.

HPD: Needs attention; flirtatious, manipulative; lacks empathy; overestimates intimacy of relationships.

NPD: Exploitative; self-indulgent; charming, pleasant & endearing; lacks empathy; irresponsible; jealous; needs approval and admiration.

OCPD: Very aware of social hierarchy; deferential to superiors and haughty to subordinates; polite and loyal; insist that their way is the right way to do things, because they are anxious to ensure perfection; stubborn; devoted to work which interferes with relationships.

PPD: Distrustful, secretive, suspicious, tend to isolate themselves and avoid intimacy; hypersensitive to criticism; bears grudges and blames others; reluctant to open up for fear of vulnerability.

STPD: Loners; socially anxious, apprehensive, suspicious and paranoid, which doesn’t fade as they get to know people; tends to live on the margins of society and relationships; often choose jobs with minimal social interaction that are usually below their skill level; indifferent to social norms.

SZPD: Aloof, loners, reserved, solitary; socially awkward; tend to fade into the background; happy to remain alone.

Cognitive style

How the person perceives and thinks about a problem and its solution.

ASPD: Impulsive; realistic; very aware of social cues; prone to executive dysfunction.

AVPD: Hypervigilant; distracted and preoccupied with their fears of rejection.

BPD: Inflexible (splitting) & impulsive; difficulty learning from the past; external loss of control leads them to blame others to avoid feeling powerless; emotions fluctuate between hope and despair; unstable self-image and fragmented sense of self; unable to tolerate frustration; brief psychotic episodes; dissociation; intense rage; difficulty focusing & processing information.

DPD: Suggestible and persuadable; optimistic, sometimes to the point of naïveté; uncritical; minimises difficulties and are easily taken advantage of.

HPD: Impulsive, dramatic; vague; suggestible; relies on intuition; avoids reflection and introspection as so to avoid realising their dependency on others; needs approval from others; has separate real/inner/private & constructed/outer/public selves; tendency to mimic speech patterns.

NPD: Focuses on feelings rather than facts; compulsive lying (to themselves as well as others); inflexible, impatient, persistent; superiority; unrealistic goals of success, power, ideal love.

OCPD: Rule & detail oriented; difficulty with prioritising; inflexible, unimaginative; conflicted between assertiveness & defiance vs obedience & pleasing people.

PPD: Mistrustful; hypervigilant; focuses on feelings (of paranoia) rather than facts; brief psychotic episodes; their need to find evidence for their paranoid suspicions gives them a tendency for authoritarianism.

STPD: Scattered; obsessive and tends to ruminate; superstitious, bizarre fantasies; vague ideas of reference (thinking things are about them when they’re not, e.g. someone laughing is directed at them) and magical thinking (thinking they caused something to happen by thinking about it); dissociative.

SZPD: Distracted; difficulty organising their thoughts; vague and indecisive; difficulty with introspection and reflection.

Affective style

How the person expresses and experiences emotions.

ASPD: Superficially expresses emotions; avoids emotions that will make them vulnerable; rarely feels guilt, shame or remorse; unable to tolerate boredom, depression, & frustration and needs stimulation.

AVPD: Shy & apprehensive; feels empty, sad, lonely & tense; depersonalisation.

BPD: Mood swings; inappropriately intense anger; feelings of emptiness, boredom, a “void”; emotional dysregulation.

DPD: Insecure & anxious; lacks self-confidence & fears being alone; fears abandonment & rejection; often sad or somber.

HPD: Displays intense, extreme emotions but may only feel them shallowly; sensitive to rejection; mood swings; need reassurance that they are loved.

NPD: Presents as self-confident and nonchalant; when criticised or rejected (”narcissistic injury”) they experience extreme shame which is often redirected into anger (”narc rage”/shame redirect); splitting; lacks empathy and so has difficulty with commitments.

OCPD: Somber, difficulty expressing feelings; avoids emotions that will make them vulnerable; comes across as stiff and stilted.

PPD: Cold, aloof, humourless; difficulty expressing feelings; tendency for anger and jealousy.

STPD: Cold, humourless, aloof; difficult to engage with; suspicious and mistrustful; hypersensitive; may react inappropriately for the situation or not at all.

SZPD: Humourless, cold, aloof; indifferent; lacks empathy; emotionally and socially distant; difficulty responding to other people’s feelings.

Temperament

The response pattern that reflects the person’s energy level, emotions and intensity of emotions, and how quick they react.

ASPD: Irresponsible, aggressive and impulsive.

AVPD: Irritable.

BPD: Passive (dependent subtype); hyperreactive (histrionic subtype); irritable (passive-aggressive subtype).

DPD: Low energy; fearful, sad or withdrawn; melancholic.

HPD: Hyperresponsive; needs attention from others.

NPD: Active and responsive; has special talents and developed language early.

OCPD: Irritable, difficult, anxious.

PPD: Active and hyperresponsive (narcissistic subtype); irritable (obsessive-compulsive and passive-aggressive subtypes).

STPD: Passive (schizoid subtype); fearful (avoidant subtype).

SZPD: Passive, difficulty experiencing pleasure and motivation (anhedonia).

Attachment style

Discussed in this post.

ASPD: Fearful-dismissing.

AVPD: Preoccupied-fearful.

BPD: Disorganised.

DPD: Preoccupied.

HPD: Preoccupied.

NPD: Fearful-dismissing.

OCPD: Preoccupied.

PPD: Fearful.

STPD: Fearful-dismissing.

SZPD: Dismissing.

Parental injunction

The expectation (explicit or implied) from caregivers for how the child should be or act.

ASPD: “The end justifies the means.”

AVPD: “We don’t accept you, and probably nobody else will either.”

BPD: “If you grow up, bad things will happen to me [caregiver].”; overprotective, demanding or inconsistent parenting.

DPD: “You can’t do it by yourself.”

HPD: “I’ll give you attention when you do what I want.”

NPD: “Grow up and be wonderful, for me.”

OCPD: “You must do/be better to be worthwhile.”

PPD: “You’re different. Keep alert. Don’t make mistakes.”

STPD: “You’re a strange bird.”

SZPD: “Who are you, what do you want?”

Self view

The way they view and conceptualise themselves.

ASPD: Cunning & entitled.

AVPD: Inadequate & frightened of rejection.

BPD: Identity problems involving gender, career, loyalties, and values; self-esteem fluctuates with emotions.

DPD: Pleasant but inadequate, fragile.

HPD: Needs to be noticed.

NPD: Special, unique and entitled; relies on others for self-esteem.

OCPD: Responsible for anything that goes wrong, so they must be perfect.

PPD: They’re alone and disliked because they’re different and better than others.

STPD: Different than other people.

SZPD: Different from others; self-sufficient; indifferent to everything.

World view

The way they view the world, others, and life in general.

ASPD: Life is dangerous and rules get in the way of their needs. They won’t be controlled or degraded.

AVPD: Life is unfair; even though they want to be accepted, people will reject them, so they’ll be vigilant & demand reassurance; escapes using fantasies and daydreams.

BPD: Splits between people and the world as either all-good or all-bad, resulting in commitment issues.

DPD: Other people need to take care of them because they are unable to.

HPD: Life makes them nervous, so they need attention and reassurance that they’re loved.

NPD: Life is full of opportunities; they expect admiration and respect.

OCPD: Life is unpredictable and expects too much, so they manage this by being in control and being perfectionists.

PPD: Life is unfair, unpredictable, demanding, and dangerous; they need to be suspicious and on guard against others, who are to blame for failures.

STPD: Life is strange and unusual; others have special magic intentions, so they are curious but also cautious when interacting with the world.

SZPD: Life is difficult and dangerous; if they trust no one and keep their distance from others, they won’t get hurt.

Maladaptive schema

Discussed in this post.

ASPD: Mistrust/abuse; entitlement; insufficient self-control; defectiveness; emotional deprivation; abandonment; social isolation.

AVPD: Defectiveness; social isolation; approval-seeking; self-sacrifice.

BPD: Abandonment; defectiveness; abuse/mistrust; emotional deprivation; social isolation; insufficient self-control.

DPD: Defectiveness; self-sacrifice; approval-seeking.

HPD: Approval-seeking; emotional deprivation; defectiveness.

NPD: Entitlement; defectiveness; emotional deprivation; insufficient self-control; unrelenting standards.

OCPD: Unrelenting standards; punitiveness; emotional inhibition.

PPD: Abuse/mistrust; defectiveness.

STPD: Alienation; abandonment; dependence; vulnerability to harm.

SZPD: Social isolation; emotional deprivation; defectiveness; subjugation; undeveloped self.

Optimal diagnostic criterion

One key criterion for each personality disorder, based on its ability to summarise all criteria for that PD, accurate description of behaviour, and the predictive value (ability to predict if the person has the PD or not).

ASPD: Aggressive, impulsive, irresponsible behavior.

AVPD: Avoids activities that involve being social out of fear of criticism, disapproval, or rejection.

BPD: Frantic efforts to avoid real or imagined abandonment.

DPD: Needs other people to be responsible for most major parts of their lives.

HPD: Uncomfortable not being the centre of attention.

NPD: Grandiose sense of self-importance.

OCPD: Perfectionism that interferes with life.

PPD: Paranoia, without evidence, that others are trying to harm, exploit or deceive them.

STPD: Thinking, speech, behavior, or appearance that is odd, eccentric, or peculiar.

SZPD: Doesn’t want or enjoy close relationships.

- From Sperry, Handbook of Diagnosis and Treatment of DSM-5 Personality Disorders (2016)

[zoidcrow]

Schizoid people are overtly detached, yet they describe in therapy a deep longing for closeness and compelling fantasies of intimate involvement. They appear self-sufficient, and yet anyone who gets to know them well can attest to the depth of their emotional need. They can be absent-minded at the same time that they are acutely vigilant. They may seem completely nonreactive, yet suffer an exquisite level of sensitivity. They may look affectively blunted while internally coping with what one of my schizoid friends calls “protoaffect,” the experience of being frighteningly overpowered by intense emotion. They may seem utterly indifferent to sex while nourishing a sexually preoccupied, polymorphously elaborated fantasy life. They may strike others as unusually gentle souls, but an intimate may learn that they nourish elaborate fantasies of world destruction.

McWilliams (2006)