Schizoid personality disorder - Causes, symptoms and treatment. MF.

This type of psychopathy is characterized by a significant decrease in social contacts. The schizoids show a low level of emotional expression. They do not have close relationships with others, becausesincerely prefer to be alone. Others often consider them "hermits".

Stages of becoming a schizoid personality disorder

When forming schizoid psychopathy, certain traits appear at 3-4 years of age. Such children prefer quiet, solitary occupations, do not aspire to active communication with peers, do not have strong attachments to relatives and friends. With the emerging schizoid psychopathy, children are very early in showing interest in abstract, abstract, complex philosophical problems( problems of life and death, the origin of the world, etc.).

At school age, revealing developed logical thinking, sometimes remarkable mathematical abilities, at the same time they are not adapted to everyday life, they are helpless when solving simple everyday problems. Typically, these children are fenced off from others, they are not drawn to peers, they do not participate in collective games.

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In some cases, the rudiments of the schizoid psychopathic warehouse may be found soon after birth( in the 1-3 years of life).These conditions are usually described in the framework of an uncomredient version of Kanner's syndrome or the syndrome of early childhood autism. The most characteristic of its manifestations include the violation of emotional contacts with the environment, the monotony of behavior, poor adaptation in the new environment. Such children are sharply behind the formation of speech and communicative functions, it is difficult to form elementary skills of self-service. The manifestations of the non-concordant variant of the syndrome of early childhood autism, as a rule, remain stable for several years, and further, if the state is exhausted by features of a congenital anomaly and no signs of manifestation of schizophrenia, gradual compensation of the signs of psychopathy occurs. By 5-10 years, children are becoming more adequate. Preserving the marked features of autism, they can learn, complete education, acquire professional skills.

Symptoms of schizoid personality disorder

Characteristic features of schizoids are disharmony, paradoxicality of both their appearance and behavior, and manifestations of emotional life and mental activity in general. Motorcycle schizoid is characterized by unnaturalness, lack of plasticity. In the planting of the head, gait, habitual movements, there is an angularity. Mimicry is devoid of liveliness, limited to a set of standard expressions. The voice is modulated a little, because of what quite often the conversation is conducted as though on one note. Clothes are stylized - this is either underlined sophistication, aristocratic, or, conversely, intentional negligence.

The schizoids are people of extreme feelings and emotions;they either admire or hate. The hobbies of schizoids are often peculiar, even original, as a rule, one-sided. The social significance of hobbies is different: in some, all the forces, thoughts and energy are directed toward the achievement of insignificant purposes( for example, collecting);others, on the contrary, show remarkable energy and perseverance in the creation of sometimes very talented and valuable scientific concepts. However, in either case, they remain completely indifferent to the needs of practical life, ordinary interests, the needs of the family. These people are not interested in establishing or maintaining friendly ties, show a weak interest in sexual relations and are indifferent to their family. They select a job that requires a small number of contacts with other people or is altogether devoid of such. When necessary, they can establish long-term, albeit detached, working relationships, but prefer to remain alone with themselves, often working alone throughout the day. In addition, many of them live alone and avoid social contacts. As a result, their social skills do not develop. If they marry, a lack of interest in intimacy can lead to marital or family problems.

The basis of schizoid temperament is the so-called psychoesthetic proportion, a combination of features of excessive sensitivity( hyperesthesia) and emotional coldness( anesthesia).

By the predominance of hyperesthetic or anesthetic elements in the structure of schizoid psychopathy, it is customary to distinguish two extreme types of characters, connected among themselves by a wide range of transitional variants:

sensitive schizoid - mimosa-like, hyperesthetic, with a predominance of asthenic affect;
expansive schizoids are cold, sometimes even stupid individuals with a predominance of sthenic affect.

Sensitive schizoid are people with an "extra-superficial" internal organization, painfully sensitive. They endure even a small insult for a long time, they can not free themselves from the memories of once heard rudeness. They are subtle and deeply sensitive people with a limited circle of very strong attachments and a wary attitude toward the rest of the environment. The "edge" of experiences is always directed at themselves, and the tendency to subtle self-observation sometimes comes to self-censure. Modest, dreamy, easily astheniziruyuschiesya, avoiding violent manifestations of feelings, they are at the same time morbidly proud. Stenic affect, according to TI Yudin( 1926), manifests itself in their peculiar pride: "I forgive all others, but I do not forgive myself."In the work they are extremely conscientious and thorough, strive for unilateral deepening, usually limited to a narrow range of daily duties. Under the influence of a mental trauma, which for them most often are various ethical conflicts and morally isolating situations( suspicion of any unseemly or immoral act), they easily lose their emotional balance. Appearance of depression, sluggishness, increased seclusion from the world. They lose their appetite, sleep badly, become even more incredulous. Sometimes there are fragmentary ideas of the relationship. As a rule, after a traumatic situation such schizoid reactions quickly pass, leaving the former structure of personality unchanged.

Expansive schizoids are determined, strong-willed, non-volatile, little considered with the views of others. In relationships with others, they are usually dry and formal. Strict adherence to principle is combined with indifference to the destinies of individuals. Among them, people with "bad character" are often arrogant, cold, steep, incapable of empathy, sometimes heartless and even cruel, but at the same time easily vulnerable, with deeply hidden dissatisfaction and self-doubt, capricious and bilious. They are prone to explosive( explosive) reactions. At occurrence of serious vital difficulties at them fussiness, irritability with flashes of anger and impulsive acts grow. In more severe cases, it is possible to form transient states that are close to paranoid reactions, when their inherent distrust becomes a delirious alertness or even catatonic delusional formations.

Causes of schizoid personality disorder

1. Many psychodynamic theorists, in particular, supporters of the theory of object relations, argue that the basis for schizoid personality disorder is the unmet need for contacts with people. Parents of people with this disorder, like the parents of those who suffer from a paranoid personality disorder, are believed to have disliked or even mistreated their children. People with paranoid symptoms respond to this upbringing with mistrust, while individuals with schizoid personality disorders are unable to show or accept love and therefore begin to avoid all relationships.

2. Self-psychologists, another group of psychodynamics theoreticians, speak of a "disorder" I "in schizoid personality disorder, indicating a lack of self-esteem and inability to create a comfortable environment around themselves." Uncertain of what they are, these people can notto establish relationships with others

3. Theorists of the cognitive direction, for their part, believe that schizoid individuals suffer from thought deficiencies, their thoughts are usually fuzzy and sterile, they find it difficult to assess the environment and the rightThey are unable to grasp the emotional responses of others, they can not respond to the emotions of others, according to this theory, children with schizoid personality disorder develop slowly speech and motor skills, regardless of what their intellectual level is.

4. Maudorf, G. E. Sukharev and others, the cause of schizoid psychopathy was seen in a certain constitutional deficiency of the cerebral and, perhaps, endocrine system.

5. There is also an opinion about the hereditary predisposition of this personality disorder.

Diagnosis of schizoid personality disorder

Schizoid personality disorder ( criteria for ICD-10)

is little fun and nothing at all;
emotional coldness, alienated or flattened affectivity;
inability to show warm, tender feelings towards other people, as well as anger;
weak response to both praise and criticism;
little interest in sexual contacts with another person

( taking into account age);

increased concern about fantasy and introspection;
almost unchanged preference for solitary activity;
noticeable inconsistency to the prevailing social norms and conditions;
the absence of close friends or trusting connections( or the existence of only one) and the desire to have such connections.

It should be noted:

This category includes autistic individuals with a predominance of sensitive features( "mimosa" with a hypersensitive internal organization and susceptibility to psychogenics with asthenodepressive type of reactions), as well as unstable schizoids with high performance in narrow spheres of activity in combination with formaldry) pragmatism and certain features of despotism that characterize interpersonal relations.

Excluded:

schizophrenia( F20.-);
schizotypal disorder( F21.x);
Asperger syndrome( F84.5);
schizoid disorder of childhood( F84.5);
delusional disorder( F22.0x).

Treatment of schizoid personality disorder

Medical therapy is ineffective.

Already socially isolated, people with this personality disorder usually begin treatment only because of some other disorder, for example due to alcoholism. They often keep a distance between themselves and the therapist, apparently, do not worry about the course of treatment and in their condition there are, at best, minor improvements.

· Cognitive therapists sometimes manage to help these people experience more positive emotions. Their techniques include familiarizing the patient with a list of emotions that he should reflect on, or a request to recall and describe some pleasant situations.

· Behavioral therapists sometimes successfully instill in their clients social skills, using role-playing games, the controlled impact of unpleasant stimuli and homework.

· Group therapy is obviously useful when it creates an environment that is safe for social contact, although people with schizoid disorder may be uncomfortable with any attempts to get them to take part in some activity.