PERSONALITY DISORDERS

Schizoid Personality Disorder

Schizoid Personality Disorder (SPD) is characterized by a lack of attachment with others and limited expression of emotions in interpersonal relationships. Examples of these behaviors are choosing to do things alone and a lack of enjoyment when partaking in most activities.

“I am an introvert and prefer to do things alone! Does this mean I have SPD?”

Unlike having an introverted nature, individuals with SPD do not desire close relationships with others – this can include their own family.

Symptoms of SPD are usually observable by childhood and adolescence, though it is diagnosed only in early adulthood. Symptoms in childhood and adolescence include having poor peer relationships and underachievement in school. Individuals with SPD may also face difficulties in expressing emotions and conveying appropriate responses to adverse circumstances (for example, expressing anger when provoked). This may lead to the impression that they are unable to experience emotions.

Due to their lack of desire for intimacy, individuals with SPD typically have few friendships, date infrequently, and rarely marry. Occupational functioning may be impaired for some individuals too, particularly for those who work in jobs that require interpersonal involvement.  However, they might do well when they work in jobs that require minimal social interaction, and most individuals with SPD report being able to hold jobs and lead fairly normal lives.

Schizoid Personality Disorder, SchizoTYPAL Personality Disorder and SchizoPHRENIA… what’s the difference?

SPD appears to precede other psychotic illnesses, such as schizophrenia, in some cases. SPD can be quite similar to schizotypal personality disorder and schizophrenia, given that these three disorders involve a severely limited ability to establish social connections and a lack of emotional expression.

A distinctive trait of SPD is that unlike individuals with schizotypal personality disorder, they do not face anxiety or depression over their discomfort in social situations or lack of meaningful relationships in their lives.

Even so, SPD is sometimes comorbid with major depressive disorder due to other individual reasons (e.g knowing that they are socially different even though they don’t desire closeness/intimacy). SPD is most commonly co-diagnosed with schizotypal, paranoid, and avoidant personality disorders. In addition, unlike individuals with schizophrenia, individuals with SPD generally come across as being in touch with reality (that is, they do not experience paranoia and hallucinations), and have generally logical and coherent speech patterns.

How does SPD develop?

There is limited research for this personality disorder as individuals with SPD are unlikely to volunteer for research studies. Nevertheless, similar to other disorders, an intertwined nature of psychological and environmental factors (for example, the individual’s underlying schemas), as well as biological factors have been adopted to explain the disorder.

Addressing SPD 

It can be challenging to get individuals with SPD to go for therapy as they usually feel that they do not have a problem. Individuals with SPD might also be put off by the idea of going to therapy as the success of therapy is contingent on the establishment and maintenance of a therapeutic relationship–the idea of having to interact with another person--which might be aversive to some.

However, if individuals with SPD do seek therapy, there are various forms of therapy they can consider. Cognitive behaviour therapy (CBT) is a viable option for addressing SPD as it teaches the individual how they can change their thoughts about and behaviours in social situations. This is apt, considering that one of the risk factors for SPD is maladaptive thoughts that lead them to view themselves as self-sufficient loners and view others as intrusive. Therefore, CBT might be helpful in changing one’s reluctance in pursuing meaningful social relationships and they might be more willing to make positive changes in how they interact with others. Group therapy also provides a safe place for such individuals to practice social skills, thereby increasing their comfort in social situations.

Prognosis and Supporting Your Loved Ones with SPD

Given the limited amount of research on individuals with SPD, there is little evidence regarding the prognosis for such individuals. However, the general consensus on the prognosis for individuals for SPD is that it tends to be poor. Personality disorders are typically chronic and are generally challenging to address, with some individuals reporting difficulties holding a job and forming relationships with other people.

However, it is not to say that nothing can be done to support a loved one with SPD!

You can express your support for them in various ways - offer to accompany them to appointments, fetch them to therapy sessions, or listen to them talk about their experiences. Encourage them to seek out self-help support groups for individuals with SPD. Such groups function as safe spaces for them to overcome feelings of isolation, improve social skills, and develop healthy social relationships with others.

At the same time, have realistic expectations about your relationship with individuals with SPD. Know that there may be limits in the level of emotional closeness you, a friend, or family member can develop with an individual with SPD. People with SPD typically feel less pressure in interpersonal relationships that are formed based on work or other activities (e.g. common hobbies) instead of emotional attachment. Therefore, to build a relationship with them, focus on engaging in activities that are less emotionally demanding, such as an intellectual activity or a project. This is helpful in engaging with them without pressuring them to express emotions.