Schizoid personality disorder is a pattern of indifference to social relationships, with a limited range of emotional expression and experience. The disorder manifests itself by early adulthood through social and emotional detachments that prevent people from having close relationships. People with it are able to function in everyday life, but will not develop meaningful relationships with others. They are typically loners and may be prone to excessive daydreaming as well as forming attachments to animals. They may do well at solitary jobs others would find intolerable. There is evidence indicating the disorder may be the start of schizophrenia or just a very mild form of it. People with schizoid personality disorder are in touch with reality unless they develop schizophrenia.
Those with schizoid personality disorder do not have schizophrenia, but it is thought that many of the same risk factors in schizophrenia may cause schizoid personality disorder.
SYMPTOMS
Takes pleasure in few, if any, activities.
Does not desire or enjoy close relationships, including family.
Appears aloof and detached.
Avoids social activities that involve significant contact with other people.
Almost always chooses solitary activities.
Little or no interest in sexual experiences with another person.
Lacks close relationships other than with immediate relatives.
Indifferent to praise or criticism.
Shows emotional coldness, detachment or flattened affect.
Exhibits little observable change in mood.
People with schizoid personality disorder maintain contact with reality.
TREATMENT
Little research has been done on the treatment of SPD. This is partly because people with this diagnosis typically do not experience loneliness or compete with or envy people who enjoy close relationships.
People with this disorder rarely seek treatment, and little is known about which treatments work. Talk therapy may not be effective, because people with schizoid personality disorder have difficulty relating well to others. Therefore, treatment can be difficult because of initial reduced capacity or desire to form a relationship with a health professional. A non-intrusive support group can alleviate feelings of solitude, and fears of social interactions and close relationships. Individual therapy, in most cases, has proven relatively ineffective and often temporarily addresses immediate conditions instead of seeking to eliminate the disorder entirely.
MEDICATION
Medications are not usually recommended for SPD. However, they are sometimes used for short-term treatment of extreme anxiety states associated with the disorder. The presence of anxiety, usually caused by fear of other people, may mean that a diagnosis of the related schizotypal personality disorder is more appropriate.
PSYCHOTHERAPY
Individual therapy that successfully attains a long-term level of trust may be useful in certain cases of schizoid personality disorder by giving patients an outlet to transform their false perceptions of friendships into authentic relationships. As a therapist-client relationship develops, a patient can start to reveal imaginary friendships and terrors of dependency. Individual psychotherapy can gradually affect the formation of a true relationship between the patient and therapist.
Long-term psychotherapy should not be pursued because of its poor treatment outcomes and the costs inherent in lengthy therapy. Instead, therapy should focus on simple treatment goals to alleviate current pressing concerns or stressors within the individual's life.
Cognitive-restructuring may be proper to address certain types of clear, irrational thoughts that are negatively influencing the patient's behaviors. This therapeutic plan should be clearly defined at the onset of treatment. Stability and support are the keys to good treatment with someone who suffers from schizoid personality disorder. Care should be taken not to "smother" the person with schizoid personality disorder and be able to tolerate possible "acting out" behaviors.
Group therapy is another potentially effective form of treatment but it generally is not a good initial treatment.
Although patients may initially withdraw from the therapy group, they often grow participatory as the level of comfort is gradually established. Protected by the therapist, who must safeguard people with this diagnosis from criticism by others in the group, patients have the chance to conquer fears of intimacy by making social contact in a supportive environment.
Social consequences of serious mental disorders ; family disruption, loss of employment and housing are sometimes calamitous. Comprehensive treatment, including services existing beyond the formal treatment system, is crucial to ameliorate symptoms, assist recovery, and redress stigma.
Self-help programs, family self-help, advocacy and services for housing and vocational assistance complement and supplement the formal treatment system.
REFERENCE
American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
Center for Substance Abuse Treatment
Psychology Network-UK
Bateman, A. W., Gunderson, J., & Mulder, R. (2015). Treatment of personality disorder. The Lancet, 385(9969), 735-743.
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"Like a mollusk without a shell--that is the surface. Or else the surface is just nothing; we see a man who stands in our way like a question mark [...] there are schizoid men, with whom we can live for ten years and yet we may not say for certain we know them."
-E. Kretschmer (1925, From Physique and Character, pp. 146).
*When a schizoid person is aggressive, the hate is cold and unfeeling, destructive and paranoid.
*The markedly schizoid person comes into treatment complaining about feeling cut off, out of touch, and shut off; things do not feel real. Feeling almost robotic and futile.
*Many people fear their over-dependence will overwhelm the other, but it is when that fear makes the person withdraw into their internal world as a result that it is schizoid.
*The extremely schizoid person fears good and loving relationships. As soon as he gets close to someone, he experiences an unaccountable loss of interest.
*The fundamental cause of the development of the schizoid condition is the experience of isolation resulting from the loss of mental rapport.
*In summary, schizoid phenomena are on a continuum, but when the schizoid position is dominant in a patient, the analyst has to manage the patient’s unwillingness to make a commitment to the treatment and refusal to admit being effected by the analyst. Maintaining boundaries and not giving advice is extremely important to reassure the patient that you are not trying to take them over. But when the schizoid patient wants to be in another treatment at the same time; go on vacation for two months; or do his laundry instead of coming to his session, BE CALM but STAND STRONG.
She stepped out of the car with elegance, the cold wind of harmattan hitting her face, making the veil she wore fly around her face. Using her henna covered hands she drew the veil over her head, fussing over how much of a trouble it was wearing a veil during harmattan.With a sigh, she closed the door and made for the revolving doors of the mall, returning a smile to the security man as he opened the door for her. She was a regular at the Ado Bayero Mall so he was already used to seeing her.Today was the day of her Nikkah•, she was marrying the man whom she felt she wanted to marry although she didn't love him, she felt safe and comfortable around him. The knots were going to be tied in an hour yet there she was, in a mall.She snuck out of the house to watch a movie and get a new pair of Archie Comics with no care in the world, she had no idea when she was going to come back to the mall again or if she was ever coming back so she had to visit it one l
The morning breeze blew the curtains to and fro, making Najmah shiver as she descended the stairs. She placed a hand on her bare arm, making a beeline to the kitchen. Her eyes were a little bit unfocused as she hadn't slept a wink the night before, her mind too occupied and restless to let her be.If only Fahad hadn't gotten himself into trouble, she wouldn't have been in that situation, she thought solemnly. She spent the whole night trying to figure out what made him do what he did but couldn’t come up with any possible reason. His family was well off so why would he get himself caught up in such an illegal act?Something wasn’t adding up she thought as she entered the kitchen, heading towards the coffee brewer. The Fahad she knew wouldn’t have done what he was accused of but perhaps, she could be wrong. After all, she didn’t know him that much but he never gave her any reason to suspect that he was partaking in illegal activities. She sat down on the kitchen island, t
Najmah snapped her book shut then fastened her seat belt, staring out of the window. She had a phobia for flights, so she spent the whole flight duration reading one of the many books she had brought together with her; "Lie to me, Dan by Longrin Wetten″ which happened to be one of her favorites.She gripped the edge of her seat and snapped her eyes shut as the captain began the procedures for landing, muttering all the du'as• that came to her mind at that time, holding tight to her seatbelt as if her life depended on it. And much to her relief, it was a smooth landing. She took off her seatbelt with shaky hands then got her luggage from the compartment, sighing in relief when her feet came in contact with asphalt as she stepped out of the plane."Welcome to Istanbul, your new home," Mr. Faik beamed at her once they were done with airport preliminaries."Thank you, sir," she replied forcing a fake smile."Please don't," he scrunched up his face. "C
The next morning, Najmah couldn't sleep after fajr salah so she went out of the room and headed towards the the kitchen, tracing Lale's steps from the day before. She found Aslan perched on a stool sipping tea, a copy of the day's paper held in his left hand. He raised his head and their gaze met, his unreadable while hers was full of uncertainty.She whirled around to head back where she came from when she froze, his husky voice sending shivers down her spine. "Come in, I don't bite."His presence unnerved her and she wished more than anything he would leave the kitchen and let her gather her thoughts. On one hand, she could just leave like she intended to but she really needed the caffeine.Shoulders sagged down in defeat, she walked towards the espresso machine and tried to turn it on, but all her attempts were futile as she had no idea how to operate it.Aslan sensing her distress debated on whether to help her or leave her to it. Deciding on the former,
Aslan didn't sleep a wink the night before after Najmah had woken him up, he sat behind the desk of his office rubbing at his temple tiredly. Bags were visible under his eyes and the mug of coffee he kept on his table wasn't helping matters, the caffeine wasn't strong enough to ward off the effects of the nightmare.He shuddered as events of his nightmare kept replaying on his mind, he still remembered that dreadful night; the night that cost him the life of someone close to him, and almost cost him his sanity. It was a night he'd never forget."Sir? You have a meeting in five," his secretary knocked at the door of his office, interrupting his thoughts."Why didn't you tell me this earlier?" he grumbled, picking up the file on his desk. He straightened his tie, slipped on his suit which was hanging on the chair then walked out of the office with strides that demanded authority.Every employee scrambled up from his seat greeting him, while he gave a curt nod a
The sun rays penetrated through the glass walls of the greenhouse, stimulating the plants growth. Najmah was busy transferring the blooming seedlings into various pots after asking Ferah for permission who was more than happy for she was far too busy to take care of it.After successfully transferring them to the pots, she arranged them in a corner then set to plant new seeds. Using her thumb and index finger, she pinched the top of a few leggy plants, for them to grow fuller and healthier before spraying pyrethrum around the greenhouse to ward off ants and aphids.Using the back of her mud covered hand, she wiped away the tiny sheen of sweat that rolled down her face then bent down to pick a broom and began to sweep the mess she made while transplanting.When she was done, she stepped back to admire her handiwork. Satisfied with it, she turned around to go back in and take a shower when she froze, letting out a scream.
Lale stared at her reflection in the mirror, scrunching up her face in distaste. Bags were visible under her eyes and her face looked pale due to exhaustion from lack of sleep."You shall sleep when everything is set," she said to her reflection as she added another layer of foundation to her face. When she was satisfied with her look, she donned her hijab then padded to Aslan & Najmah's room.Just like she predicted Najmah was sitting on bed with a spoon hanging on her mouth, staring intently at the book she was holding, a jar of Nutella kept to her side. She never could understand the girl's obsession with books and Nutella."Hello Missy, care to join me on an adventure into town?" she queried, startling Najmah who threw her book away.Although exhausted Lale fell into a fit of laughter, clutching her stomach and pointing at the sullen look on Najmah's face."You...look...look.
Blood pounded in her ears, her heart thudding in her chest. Her hands shook as she felt a tingle in her feet. Her vision became blurry and she gripped the edge of the basin, trying to steady her breathing. Each moment that passed, breathing became harder for her.She took long measured breaths, staring at her reflection through her blurred vision. She debated on whether to bolt out and run back home or stay and face her demons.If she stayed, she was likely to make a mess of herself. If she left, Lale would be really disappointed. Either way, there was a sure risk on both of her decisions, besides if she left, she had no idea how to get home."Najmah are you okay in there?" Aslan queried, knocking on the door of the bathroom.She couldn't give him a coherent answer due to her lack of breaths. Sensing something wrong, he ran into the bathroom and found her hunched over the basin."Hey