Schizoid personality disorder

By Adok/Hugi

"A 22-year-old computer science student enters the doctor's practice. At first contact he appears reserved and cool. Taciturnly and concisely, he talks about his experiences so far and states that he had very good marks at high school. However, he had no friends and was a loner. Back at school he did not feel lonely because he was proud of his good marks. At university he also had hardly any contact with his fellow students, he saw them only during the lectures and at exams. He has never had a partner relationship and does not even want one. Three months ago he started an internship at a company. Here he is forced to work in a team and deal with other people. As a result of this, his colleagues, who had first welcomed him in a friendly way, withdrew from him to an increasing extent. He is discouraged, dissatisfied and fears that he will not be able to successfully complete the internship and become a computer scientist."

(Translated from Möller et al., "Psychiatrie und Psychotherapie")

Does this story appear familiar to you? Then you might be having schizoid personality disorder. The International Classification of Diseases 10 (ICD-10) defines personality disorders as "conditions in which the characteristical inner experience and behaviour patterns deviate strongly from culturally expected and accepted norms". This deviation concerns cognition, affectivity and interpersonal relationships.

Schizoid personality disorder is characterized by "a lack of interest in social relationships, a tendency towards a solitary lifestyle, and emotional coldness" (Wikipedia). It resembles the type of personality that is commonly labelled "geek" or "nerd". It is quite a rare disorder: only about 1% of the general population are affected.

The ICD-10 has a list of criteria for schizoid personality disorder. If three or more criteria are matched, the psychiatrist is allowed to make the diagnosis. Here are the ICD-10 criteria:

1. Taking pleasure in few, if any, activities.

2. Emotional coldness, detachment or reduced affectivity.

3. Limited capacity to express either positive or negative emotions towards others.

4. Indifference to either praise or criticism.

5. Lack of desire for sexual experiences with another person.

6. Consistent preference for solitary activities.

7. Preoccupation with fantasy and introspection.

8. Very few (if any) close friends or relationships, and a lack of desire for such.

9. Indifference to social norms and conventions.

If you match these criteria and feel that your life is badly affected by this disorder, you can see a psychiatrist to get treated. Schizoid personality disorder is treated by psychotherapy. At the beginning the therapist will try to establish a therapeutic relationship by means of a gentle approach and empathic attention. This way you will be helped to overcome your fear of close relationships.

In a cognitive-behavioral therapy, emphasis will be made on the analysis of the individual feedback circles, consisting of few social interactions, limited social abilities, failures at attempts to establish contacts and consequent retreat. The value of social abilities and ways to adapt the environment to your own possibilities and needs will be shown. The progress in therapy will be continously accompanied with role-plays or video feedback.

Adok/Hugi