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Understanding the Complexities of Schizoid Personality Disorder: A Dialectical Perspective

According to the DSM-5-TR, schizoid personality is characterized by detachment from social relationships and a restricted range of emotional expressiveness. This is often comorbid with autism diagnoses. However, that does not mean that every person with schizoid will present the same, nor does it mean that this personality disorder, like all others, does not exist on a spectrum. 

Many of those with schizoid do tend to have small, close-knit circles, typically consisting of family members, but there are also those that occasionally seek the company of others. When speaking of schizoid in the public sphere, what most will say is that rather than being detached from the need for socializing, it is more that they lack it. This does not equate to disliking social interactions, or going out of their way to manipulate others, as is characteristic of those with antisocial personality disorder. Rather, schizoid personalities are characterized by perceiving such interaction as unnecessary. Thus, they tend to not put more effort into a conversation they lack interest in, than needed. This is a trait that overlaps in many people with autism, providing some context behind the comorbidity.

Schizoid has, in recent research, shown indications of being a precursor to or a genetic sign of a predisposition to schizotypal personality disorder, or schizophrenia. Again, correlation does not equal causation, but there are enough cases that it is a valuable point to keep in mind. Those with schizoid can also often be isolated in childhood, as, along with many other personality disorders, factors in the environment play as important a role as do genetic factors. Finally, take note of cultural differences–certain cultures present as less emotionally expressive or volatile than others, and this is an important factor when considering this diagnosis.

Schizoid personality makes for good surgeons

Those with schizoid personality disorder tend to do well in the medical and business fields, as well as the sciences in general. For example, being socially detached lends well to being able to perform surgery without intensely empathizing with the patient on the operating table. In other words, while a highly empathic person might falter, someone who is less so will be focused on accomplishing the task–which, at the end of the day, involves saving a life. A lowered level of empathy does not equate to lacking a moral code at all, naturally–many of those with schizoid personality have solid moral codes they personally adhere to, and it is this kind of thing that may allow them to become valued lawyers or doctors, among other things.

What About Treatment?

Rarely will a person with schizoid actively come to treatment. If you are content with your lifestyle, then there is no need to seek change–thus, there is no need to seek treatment that encourages change. Yet there are just as many people who have the schizoid diagnosis that often find themselves depressed with the state of their life–perhaps, though they do not seek social connection, they feel a sense of boredom, or a lack of fervor for life. In many cases, those who do come for treatment are encouraged to do so by others, and lack real motivation themselves, hindering the formation of a therapeutic alliance.

There are a multitude of treatment modalities that have been considered when working with a person that may have schizoid personality disorder. One is CBT, or cognitive behavioral therapy. The primary goal here would be to reframe social tasks as useful rather than unnecessary, and to facilitate the development of hobbies and other activities with the mindset that they are necessary for mental well-being and enrichment rather than a waste of time, or boring. DBT, or dialectical behavior therapy, encourages seeing multiple perspectives at once, and one of the key tenets is learning interpersonal effectiveness. This would encourage the development of social connection by providing the skills necessary for it, even if the person themselves is not necessarily in a position to or even likely to use them often, because the skill set remains in their toolkit. Those with schizoid may also benefit from RO-DBT, a reformatted variant of DBT specifically for those who tend to restrain themselves more as opposed to those who tend to give into their impulses.

If you believe you have schizoid personality, have been diagnosed with schizoid personality, or share any of these traits, and would like to seek coaching in any of these aspects, consider looking into the above forms of treatment modalities. Know that it is not necessarily wrong or right to be more or less social. At the end of the day, you are the one who decides what you need in your life to be happy.

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