Schizoid Psychoanalytic Diagnosis

Schizoid Personalities

The person whose character is essentially schizoid is subject to widespread misunderstanding, based on the common misconception that schizoid dynamics are always suggestive of grave primitivity. Because the incontrovertibly psychotic diagnosis of schizophrenia fits people at the disturbed end of the schizoid continuum, and because the behavior of schizoid people can be unconventional, eccentric, or even bizarre, nonschizoid others tend to pathologize those with schizoid dynamics-whether or not they are competent and autonomous, with significant areas of ego strength. In fact, schizoid people run the gamut from the hospitalized catatonic patient to the creative genius.

As with the other typological categories, a person may be schizoid at any level, from psychologically incapacitated to saner than average. Because the defense that defines the schizoid character is a primitive one (withdrawal into fantasy), it may be that healthy schizoid people are rarer than sicker ones, but I do not know of any research findings or disciplined clinical observations that support this assumption empirically. There is long-standing evidence and some recent suggestions from neuroscience and genetics that the most frequent premorbid personality type in those who become schizophrenic is schizoid. But the converse idea, that all schizoid people are at risk of a psychotic break, has no empirical basis.

One reason schizoid people may be pathologized is that they are comparatively rare. People in majorities tend to assume that their own psychology is normative and to equate difference with inferiority (as happened with people of minority sexual orientation for many years). The psychoanalytic concept of the schizoid person has a lot in common with the Jungian concept of the introvert, specifically the kind of individual who would test as an introverted, intuitive, feeling, judging type on the Jungian-derived Myers Briggs inventory. These types constitute only about one percent of the overall population in the areas where personality distribution has been studied, and are understood as having strengths as "mystics" or "confidants."

Vocations like philosophical inquiry, spiritual discipline, theoretical science, and the creative arts attract people with this kind of character. At the high-functioning end of the schizoid spectrum we might find people like Ludwig Wittgenstein, Martha Graham, and other admirably original and somewhat eccentric individuals. Albert Einstein wrote about himself:

In nineteen eighty, with the publication of DSM-III, conditions that most analysts would regard as different possibilities on the schizoid spectrum, or as minor variants on a general schizoid theme, appeared as discrete categories in the DSM. Complicated theoretical issues influenced this decision, one reflecting differences of current opinion that echo old controversies about the nature of certain schizoid states. Many analytic practitioners continue to regard the diagnoses of schizoid, schizotypal, and avoidant personality disorders as nonpsychotic versions of schizoid character, and the diagnoses of schizophrenia, schizophreniform disorder, and schizoaffective disorder as psychotic levels of schizoid functioning.

I am often asked whether I see schizoid people as on the autistic spectrum, and I am not sure how to answer. Our taxonomic categories remain arbitrary and overlapping, and acting as if there are discrete present-versus-absent differences between labels is not usually wise clinically, when one is trying to get a sense of a patient's individual uniqueness. Perhaps schizoid psychology, especially in its high-functioning versions, can be reasonably viewed as at the healthy end of the autistic spectrum. Certainly on the basis of their observable behavior, some schizoid individuals seem as unrelated, odd, and detached as those with diagnosed autism or Asperger syndrome.

But people who are diagnosably autistic often report an internal inability to imagine what others are thinking and feeling and being motivated by, whereas schizoid people, despite their withdrawal, are more likely to be preternaturally attuned to the subjective experience of others. I have heard Asperger-diagnosed parents say that they had to be taught that their children need to be hugged. Even if he had trouble getting himself to hug his child, a schizoid father would have no difficulty understanding the child's need. Schizoid people are more likely to describe themselves as overwhelmed by affect than as lacking it. So in these areas there seems to me a significant difference in the territory under consideration.

DRIVE, AFFECT, AND TEMPERAMENT IN SCHIZOID PSYCHOLOGY

Clinical experience suggests that temperamentally, the person who becomes schizoid is hyperreactive and easily overstimulated. Schizoid people often describe themselves as innately sensitive, and their relatives frequently mention their having been the kind of baby who shrinks from too much light or noise or motion. It is as if the nerve endings of schizoid individuals are closer to the surface than those of the rest of us. Doidge depicts them as "hyperpermeable" to external impingements. Although most infants cuddle, cling, and mold themselves to the body of a warm caregiver, some newborns stiffen or pull back as if the adult has intruded on their comfort and safety. One suspects that such babies are constitutionally prone to schizoid personality structure, especially if there is a "poor fit" between themselves and their main caregivers.

In the area of drive as classically understood, the schizoid person seems to struggle with oral-level issues. Specifically, he or she is preoccupied with avoiding the dangers of being engulfed, absorbed, distorted, taken over, eaten up. A talented schizoid therapist in a supervision group I belonged to once described to the group members his vivid fantasy that the physical circle of participants constituted a huge mouth or a giant letter C. He imagined that if he exposed his vulnerability by talking candidly about his feelings toward one of his patients, the group would close around him, making the C into an O, and that he would suffocate and expire inside it.

While fantasies like those of my colleague invite the interpretation that they constitute projections and transformations of the fantasizer's own hunger, the schizoid person often does not experience appetitive drives as coming from within the self. Rather, the outer world feels full of consuming, distorting threats against security and individuality. Fairbairn's understanding of schizoid states as "love made hungry" addresses not the day-to-day subjective experience of the schizoid person but the dynamics underlying the opposite and manifest tendencies: to withdraw, to seek satisfactions in fantasy, to reject the corporeal world. As Kretschmer noted in nineteen twenty-five, schizoid people are even apt to be physically thin, so removed are they from emotional contact with their own greed.

Similarly, schizoid people do not impress one as being highly aggressive, despite the violent content of some of their fantasies. Their families and friends often regard them as unusually gentle, placid people. A friend of mine, whose general brilliance and schizoid indifference to convention I have long admired, was described lovingly at his wedding by an older sister as having always been a "soft person." This softness exists in fascinating contradiction to his affinity for horror movies, true-crime books, and visions of apocalyptic world destruction. The projection of drive can be easily assumed, but this man's conscious experience-and the impression he makes on others-is of a sweet, low-keyed, lovable eccentric. Most analytic thinkers who have worked with people like my friend have inferred that schizoid clients bury both their hunger and their aggression under a heavy blanket of defense.

Affectively, one of the most striking aspects of many high-functioning individuals with schizoid dynamics is their lack of common defenses. They tend to be in touch with many emotional reactions at a level of genuineness that awes and even intimidates their acquaintances. It is common for the schizoid person to wonder how everybody else can be lying to themselves so effortlessly when the harsh facts of life are so patent. Part of the alienation from which schizoid people suffer derives from their experiences of not having their own emotional, intuitive, and sensory capacities validated-because others simply do not see what they do. The ability of a schizoid person to perceive what others disown or ignore is so natural and effortless that he or she may lack empathy for the less lucid, less ambivalent, less emotionally harrowing world of nonschizoid peers.

Schizoid people do not seem to struggle quite the way narcissistic people do with shame or introjectively depressive people do with guilt. They tend to take themselves and the world pretty much as is without the internal impetus to make things different or to shrink from judgment. Yet they may suffer considerable anxiety about basic safety. When they feel overwhelmed, they hide- either literally with a hermit's reclusiveness or by retreat into their imagination. The schizoid person is above all else an outsider, an onlooker, an observer of the human condition. One of my schizoid friends told me his tombstone should read, "Here lies. He read and thought about life to the hilt."

The "split" implied in the etymology of the word "schizoid" exists in two areas: between the self and the outside world, and between the experienced self and desire. When analytic commentators refer to split experience in schizoid people, they refer to a sense of estrangement from part of the self or from life that is essentially "dissociative." The defense mechanism of splitting, in which a person alternately expresses one ego state and then another opposite one, or divides the world defensively into all-good and all-bad aspects, is a different use of the word.