IRC-Galleria

Narcissistic Personality Disorder


Neurotic Solution: Narcissistic Type
Self-Confident Personality Type
Values of the Self- Confident Type New!



Perspectives q.v.

* Disease
* Dimensional
* Behavior
* Life Story





The Disease Perspective

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (American Psychiatric Association, 1994, pg. 661) describes Narcissistic Personality Disorder as a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

* has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements);

* is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love;

* believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions);

* requires excessive admiration;

* has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations;

* is interpersonally exploitive, i.e., takes advantage of others to achieve his or her own ends;

* lacks empathy: is unwilling to recognize or identify with the feelings and needs of others;

* is often envious of others or believes that others are envious of him or her;

* shows arrogant, haughty behaviors or attitudes.





The Dimensional Perspective

Here is a hypothetical profile, in terms of the five-factor model of personality, for Narcissistic Personality Disorder (speculatively constructed from McCrae, 1994, pg. 306) (Cf. Compensatory Narcissistic):


High Neuroticism
Chronic negative affects, including anxiety, fearfulness, tension, irritability, anger, dejection, hopelessness, guilt, shame; difficulty in inhibiting impulses: for example, to eat, drink, or spend money; irrational beliefs: for example, unrealistic expectations, perfectionistic demands on self, unwarranted pessimism; unfounded somatic concerns; helplessness and dependence on others for emotional support and decision making.

High Extraversion
Excessive talking, leading to inappropriate self-disclosure and social friction; inability to spend time alone; attention seeking and overly dramatic expression of emotions; reckless excitement seeking; inappropriate attempts to dominate and control others.

Low Openness
Difficulty adapting to social or personal change; low tolerance or understanding of different points of view or lifestyles; emotional blandness and inability to understand and verbalize own feelings; alexythymia; constricted range of interests; insensitivity to art and beauty; excessive conformity to authority.

Low Agreeableness
Cynicism and paranoid thinking; inability to trust even friends or family; quarrelsomeness; too ready to pick fights; exploitive and manipulative; lying; rude and inconsiderate manner alienates friends, limits social support; lack of respect for social conventions can lead to troubles with the law; inflated and grandiose sense of self; arrogance.

Low Conscientiousness
Underachievement: not fulfilling intellectual or artistic potential; poor academic performance relative to ability; disregard of rules and responsibilities can lead to trouble with the law; unable to discipline self (e.g., stick to diet, exercise plan) even when required for medical reasons; personal and occupational aimlessness.





Character Weaknesses and Vices


Pride, vanity, vainglory, superbia, superiority, hubris, overbearingness, haughtiness, separateness, insensitivity, self-importance, egoism, ego-centricity, wrath, arrogance, malice, hypocrisy, skepticism, ignorance.



Psychiatric*

* exploitive
* grandiose
* feels unique
* preoccupied with success
* feels entitled
* seeks admiration
* unempathic
* envious
* hypersensitive to criticism


Know Your Major Weaknesses

narcissistic.boss - Google Search


* Derived from Michael Stone's (pg. 22) list of the "personality traits" of DSM-III-R Narcissistic Personality Disorder.




The Behavior Perspective

* Google Search: narcissistic behavior.therapy
* Google Search: comorbidity narcissistic personality





The Life Story Perspective



Childhood



Universal Character Disorder Antisocial


Stoic explanation

Narcissistic personality disorder is a typological representation of bad character, of a vicious disposition formed by habitual passion. Passions are, or are the results of, erroneous value-judgments. The objects of passion listed below (derived mostly from Beck, Freeman, and associates, 1990, pp. 49-50) are external, indifferent things that the Narcissistic personality incorrectly judges to be good or bad. (Evolutionary Psychology and Behavior Genetics provide adequate scientific explanations of the origins of these impulses.) The cure of Narcissistic personality disorder will require correcting these habitual, erroneous value-judgments by making proper use of impressions.


Niebuhrian / Horneyan explanation

Narcissistic character disorder is a type of "solution" to the problem of anxiety; that is, it is a strategy to alleviate anxiety. The objects of desire and pleasure listed below (derived mostly from Beck, Freeman, and associates, 1990, pp. 49-50) are limited goods pridefully turned to for security when we fail to trust God. They are analogous to Karen Horney's "neurotic needs."

Karen Horney: Intrapsychic Strategies of Defense

The Expansive Solution

Narcissistic type

"Even when we deeply value ourselves, the anxiety built into finitude will tempt us to find our source of security in some strategy rather than a trust in God" (Cooper, pg. 163).


Habitual Passions

Desires/ Pleasures

Fears/ Distresses

* being admired
* aggrandizement
* being special
* being unique
* status
* superior image
* superiority
* special favors
* favorable treatment
* prestige
* dispensations
* privileges
* prerogatives
* acknowledgment of superiority by others
* being above the rules
* glory
* wealth
* position
* power
* success
* ambition
* competitiveness



* being scorned
* being criticized
* being seen as common
* being ordinary
* being seen as inferior
* failure
* others not according them admiration and respect



Cognitive Effects

Basic Belief: I am special. [Strategy]: Self-aggrandizement (Beck, Freeman & associates, pg. 26).

The "idealized self is made up of beliefs about how we should feel, think, or act" (Tamney, pg. 32).

Compulsive beliefs and attitudes are idols, too.

In Cognitive Therapy of Personality Disorders, Aaron T. Beck, Arthur Freeman, and associates (1990) list typical beliefs associated with each specific personality disorder. According to my view, the beliefs and attitudes rationalize and reinforce the idealized image and the compulsive attachments and aversions. They are analogous to Karen Horney's "shoulds" and "neurotic claims." Here are the typical beliefs that they have listed (pp. 361-362) for Narcissistic Personality Disorder:

* I am a very special person.
* Since I am so superior, I am entitled to special treatment and privileges.
* I don't have to be bound by the rules that apply to other people.
* It is very important to get recognition, praise, and admiration.
* If others don't respect my status, they should be punished.
* Other people should satisfy my needs.
* Other people should recognize how special I am.
* It's intolerable if I'm not accorded my due respect or don't get what I'm entitled to.
* Other people don't deserve the admiration or riches that they get.
* People have no right to criticize me.
* No one's needs should interfere with my own.
* Since I am so talented, people should go out of their way to promote my career.
* Only people as brilliant as I am understand me.
* I have every reason to expect grand things.



Beck's Cognitive Therapy for Personality Disorders



* Google Search: narcissistic cognitive.therapy
* Google Search: narcissistic cognitive.behavioral.therapy
* Google Search: narcissistic psychoanalytic therapy
* Google Search: narcissistic psychodynamic therapy
* Google Search: narcissistic interpersonal therapy
* Google Search: narcissistic humanistic therapy
* Google Search: narcissistic existential therapy





American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. 4th ed. Washington: Author.

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. 4th ed., text revision. Washington: Author.

Beck, Aaron T. and Freeman, Arthur M. and Associates (1990). Cognitive Therapy of Personality Disorders. New York : Guilford Press.

Beck, Aaron T. and Freeman, Arthur M. and Associates (2003). Cognitive Therapy of Personality Disorders, 2nd ed. New York : Guilford Press.

Cooper, Terry D. (2003). Sin, Pride, and Self-Acceptance: The Problem of Identity in Theology and Psychology. Downers Grove, IL: InterVarsity Press.

Gunderson, John G. and Philips, Katherine A. (1995). Personality Disorders. Comprehensive Textbook of Psychiatry/VI, Vol. 2. Eds. Harold I. Kaplan and Benjamin J. Sadock. Baltimore: Williams & Wilkins.

McCrae, Robert R. (1994). "A Reformulation of Axis II: Personality and Personality-Related Problems." Costa, Paul T., Jr., Widiger, Thomas A., editors. Personality Disorders and the Five-Factor Model of Personality. Washington, D.C.: The American Psychological Association.

(1989). Personality Disorders: Narcissistic Personality Disorder. Treatments of Psychiatric Disorders, Vol. 3. American Psychiatric Association. Task Force on Treatments of Psychiatric Disorders. Washington, DC : American Psychiatric Association.

Stone, Michael H. (1993). Abnormalities of personality: within and beyond the realm of treatment. New York: W.W. Norton.

Tamney, Joseph B. (2002). The Resilience of Conservative Religion. New York: Cambridge UP.



Sigmund Freud and Wilhelm Reich

In a 1931 paper, "Libidinal Types," Sigmund Freud described the narcissistic personality:

The characteristics of the third type, justly called the narcissistic, are in the main negatively described. There is no tension between ego and super-ego - indeed, starting from this type one would hardly have arrived at the notion of a super-ego; there is no preponderance of erotic needs; the main interest is focused on self-preservation; the type is independent and not easily overawed. The ego has a considerable amount of aggression available, one manifestation of this being a proneness to activity; where love is in question, loving is preferred to being loved. People of this type impress others as being 'personalities'; it is on them that their fellow-men are specially likely to lean; they readily assume the role of leader, give a fresh stimulus to cultural development or breakdown existing conditions.

Wilhelm Reich first described the "phallic-narcissistic character" in 1926, and later included the description in Character Analysis.

Even in outward appearance, the phallic-narcissistic character differs from the compulsive and the hysterical character. While the compulsive character is predominantly inhibited, self-controlled and depressive, and while the hysterical character is nervous, agile, apprehensive and labile, the typical phallic-narcissistic character is self-confident, often arrogant, elastic, vigorous and often impressive. The more neurotic the inner mechanism, the more obtrusive are those modes of behavior. As to bodily type, they belong most frequently to Kretschmer's athletic type. The facial expression usually shows hard, sharp masculine features, but often also feminine, girl-like features in spite of athletic habitus. Everyday behavior is never crawling as in passive-feminine characters but usually haughty, either cold and reserved or derisively aggressive, or "bristly," as one of these patients put it. In behavior toward the object, the love object included, the narcissistic element always dominates over the object-libidinal, and there is always an admixture of more or less disguised sadistic traits.

Such individuals usually anticipate any expected attack with an attack on their part. Their aggression is very often expressed not so much in what they say or do as in the manner in which they say or do things. Particularly to people who do not have their own aggression at their disposal they appear as aggressive and provocative. The outspoken types tend to achieve leading positions in life and resent subordination unless they can - as in the army or other hierarchic organizations - compensate for the necessity of subordination by exerting domination over others who find themselves on lower rungs of the ladder. If their vanity is hurt, they react either with cold reserve, deep depression or lively aggression. In contrast to other characters, their narcissism expresses itself not in an infantile manner but in exaggerated display of self-confidence, dignity and superiority, in spite of the fact that the basis of their character is no less infantile than that of others.

Freud, Sigmund (1931). Libidinal Types. Collected Papers, Vol. 5, 1959). New York: Basic Books.

Reich, Wilhelm (1949). Character Analysis, 3rd ed. New York: Farrar, Straus, & Giroux.



Narcissistic and Compensatory Narcissistic Personality Disorders differentiated

In a chapter of Disorders of Narcissism : Diagnostic, Clinical, and Empirical Implications, "DSM Narcissistic Personality Disorder: historical reflections and future directions," Theodore Millon differentiates Narcissistic from Compensatory Narcissistic Personality Disorder:

Reich (1933/1949) captured the essential qualities of what here is termed the elitist narcissistic person when he described the "phallic-narcissist" character as a self-assured, arrogant, and energetic person "often impressive in his bearing.., and.., ill-suited to subordinate positions among the rank and file" (p. 217). As with the compensatory narcissistic person, the elitist narcissistic person is more taken with an inflated self-image than with his or her actual self. Both narcissistic types create a facade that bears minimal resemblance to the actual person. However, the compensatory narcissistic person knows at some level that he or she is in fact a fraud, whereas the elitist narcissistic person is deeply convinced of his or her superior self-image, albeit one that is grounded on few realistic achievements. To elitist narcissistic persons, it is the appearance of things that is perceived as objective reality; an inflated self-image is their intrinsic substance. Only when these illusory elements to self-worth are seriously undermined will the individual be able to recognize, perhaps even to acknowledge, his or her deeper shortcomings.

---

Schizotypal Personality Disorder


Neurotic Solution: Schizotypal Type
Idiosyncratic Personality Type
Values of the Idiosyncratic Type New!



Perspectives q.v.

* Disease
* Dimensional
* Behavior
* Life Story





The Disease Perspective

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (American Psychiatric Association, 1994, pg. 645) describes Schizotypal Personality Disorder as a pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

* ideas of reference (excluding delusions of reference);

* odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitiousness, belief in clairvoyance, telepathy, or "sixth sense"; in children and adolescents, bizarre fantasies or preoccupations);

* unusual perceptual experiences, including bodily illusions;

* odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped);

* suspiciousness or paranoid ideation;

* inappropriate or constricted affect;

* behavior or appearance that is odd, eccentric, or peculiar;

* lack of close friends or confidants other than first-degree relatives;

* excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self.

The disorder does not occur exclusively during the course of Schizophrenia, a Mood Disorder With Psychotic Features, another Psychotic Disorder, or a Pervasive Developmental Disorder.





The Dimensional Perspective

Here is a hypothetical profile, in terms of the five-factor model of personality, for Schizotypal Personality Disorder (speculatively constructed from McCrae, 1994, pg. 306):


High Neuroticism
Chronic negative affects, including anxiety, fearfulness, tension, irritability, anger, dejection, hopelessness, guilt, shame; difficulty in inhibiting impulses: for example, to eat, drink, or spend money; irrational beliefs: for example, unrealistic expectations, perfectionistic demands on self, unwarranted pessimism; unfounded somatic concerns; helplessness and dependence on others for emotional support and decision making.

Low Extraversion
Social isolation, interpersonal detachment, and lack of support networks; flattened affect; lack of joy and zest for life; reluctance to assert self or assume leadership roles, even when qualified; social inhibition and shyness.

High Openness
Preoccupation with fantasy and daydreaming; lack of practicality; eccentric thinking (e.g., belief in ghosts, reincarnation, UFOs); diffuse identity and changing goals: for example, joining religious cult; susceptibility to nightmares and states of altered consciousness; social rebelliousness and nonconformity that can interfere with social or vocational advancement.

Low Agreeableness
Cynicism and paranoid thinking; inability to trust even friends or family; quarrelsomeness; too ready to pick fights; exploitive and manipulative; lying; rude and inconsiderate manner alienates friends, limits social support; lack of respect for social conventions can lead to troubles with the law; inflated and grandiose sense of self; arrogance.

High Conscientiousness
Overachievement: workaholic absorption in job or cause to the exclusion of family, social, and personal interests; compulsiveness, including excessive cleanliness, tidiness, and attention to detail; rigid self-discipline and an inability to set tasks aside and relax; lack of spontaneity; overscrupulousness in moral behavior.



Specific Affects

Social anxiety, phobic anxiety, anhedonia, feelings of humiliation, paranoia (Stone, pp. 2719, 2220, 2724, 2726).



Character Weaknesses and Vices*

* referentiality*
* social anxiety*
* illusions*
* magical thinking*
* no close friends*
* odd speech*
* inappropriate affect*
* eccentric
* suspicious


Know Your Major Weaknesses


* Derived from Michael Stone's (pg. 22) list of the "personality traits" of DSM-III-R Schizotypal Personality Disorder. Descriptors marked with an asterisk, he says, are not true personality traits.




The Behavior Perspective



Motivations

Want to avoid being influenced by anyone.



Behaviors

Aloofness, odd communication, isolation; Ego-boundary problems, "ego-diffusion," merging phenomena and other severe distortions of the self, mirroring, narcissistic disturbances, faulty sense of identity; difficulty sensing what other people are all about or else at knowing how to best respond when their perceptions of interpersonal situations happen to be accurate; marked peculiarities of speech, dress, and habit; sensitivity to criticism, avoidance of intimacy; insensitivity to the feelings of spouse, oversensitivity to spouse's behavior; extreme loneliness and need for human relatedness, inability to "connect" meaningfully and pleasurably with other people (Stone, pp. 2719, 2221-2726).

Odd speech: vague, circumstantial, metaphorical, overelaborate, or stereotyped speech; idiosyncratic phrasing, unusual use of words, overly concrete or abstract responses to questions; odd, eccentric, or peculiar mannerisms or dress; excessive social anxiety associated with paranoid fears about the motivations of others, rather than with negative judgments about themselves; difficulty responding to interpersonal cuing and expressing a full range of affects; difficulty in developing rapport or engaging in casual and meaningful conversations; an inappropriate, stiff, or constricted manner (Gunderson and Philips, pg. 1437).

Associated Disorders

Symptoms of anxiety, depression, or other dysphoric affects; transient psychotic episodes; Brief Psychotic Disorder, Schizophreniform Disorder, Delusional Disorder, Schizophrenia; Major Depressive Disorder (American Psychiatric Association, 2000, pg. 698-699).

Hypochondriasis, transient psychotic experiences; "psychoticism," obsessive-compulsive symptoms (Stone, pp. 2723-2726).



* Google Search: schizotypal behavior.therapy
* Google Search: comorbidity schizotypal personality





The Life Story Perspective



Childhood

Physical, sexual, and emotional trauma.



Universal Character Disorder Compensatory Narcissistic


Stoic explanation

Schizotypal personality disorder is a typological representation of bad character, of a vicious disposition formed by habitual passion. Passions are, or are the results of, erroneous value-judgments. The objects of passion listed below (derived mostly from Oldham, pp. 252-66) are external, indifferent things that the Schizotypal personality incorrectly judges to be good or bad. (Evolutionary Psychology and Behavior Genetics provide adequate scientific explanations of the origins of these impulses.) The cure of Schizotypal personality disorder will require correcting these habitual, erroneous value-judgments by making proper use of impressions.


Niebuhrian / Horneyan explanation

Schizotypal character disorder is a type of "solution" to the problem of anxiety; that is, it is a strategy to alleviate anxiety. The objects of desire and pleasure listed below (derived mostly from Oldham, pp. 252-66) are limited goods pridefully turned to for security when we fail to trust God. They are analogous to Karen Horney's "neurotic needs."

Karen Horney: Intrapsychic Strategies of Defense

The Resignation Solution

"Even when we deeply value ourselves, the anxiety built into finitude will tempt us to find our source of security in some strategy rather than a trust in God" (Cooper, pg. 163).


Habitual Passions

Desires/ Pleasures

Fears/ Distresses

* non-conformity
* dreaming
* the spirit
* visions
* mysticism
* eccentricity
* freethinking
* idiosyncratic feelings and belief systems, worldview, and approach to life
* odd habits
* self-direction
* independence
* the occult
* the extrasensory
* the supernatural
* abstract and speculative thinking
* being inner-directed
* observing others
* new experiences and feelings
* rapture
* freedom from rules



* conformity
* convention
* tradition
* close relationships
* how other people react to them
* that others think them strange
* old belief systems
* joining
* affiliation
* adapting
* accepting or espousing anyone else's principles and beliefs
* standard explanations
* ridicule
* doubt
* uncertainty
* disillusionment
* the "regular" world
* narrow-minded people
* normal behavior standards
* others' expectations
* accepting authority



Cognitive Effects

Basic Belief: I need to consider only my own views; I must not be influenced by anyone. Strategy: Eccentric thinking.

Suspiciousness, ideas of reference, illusions; "cognitive slippage," a disturbing sense of discontinuity with respect to time and person; tendency to misinterpret: reacts to symbols, to possible meanings, rather than facts; poor at generalizing from one situation to another analogous one; concreteness, and humorlessness; conviction of unlikeablity (Stone, pp. 2719, 2221, 2725, 2726).

Parataxic thinking.

The "idealized self is made up of beliefs about how we should feel, think, or act" (Tamney, pg. 32).

Compulsive beliefs and attitudes are idols, too.

In Cognitive Therapy of Personality Disorders, Aaron T. Beck and Arthur Freeman (1990) list typical beliefs associated with each specific personality disorder. According to my view, the beliefs and attitudes rationalize and reinforce the idealized image and the compulsive attachments and aversions. They are analogous to Karen Horney's "shoulds" and "neurotic claims." Here are some of the typical attitudes and assumptions that they have listed (pg. 140) for Schizotypal Personality Disorder:

* I feel like an alien in a frightening environment.
* Since the world is dangerous, you have to watch out for yourself at all times.
* There are reasons for everything. Things don't happen by chance.
* Sometimes my inner feelings are an indication of what is going to happen.
* Relationships are threatening.
* I am defective.



Beck's Cognitive Therapy for Personality Disorders



* Google Search: schizotypal cognitive.therapy
* Google Search: schizotypal cognitive.behavioral.therapy
* Google Search: schizotypal psychoanalytic therapy
* Google Search: schizotypal psychodynamic therapy
* Google Search: schizotypal interpersonal therapy
* Google Search: schizotypal humanistic therapy
* Google Search: schizotypal existential therapy





American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. 4th ed. Washington: Author, 1994.

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. 4th ed., text revision. Washington: Author.

Beck, Aaron T. and Freeman, Arthur M. and Associates (1990). Cognitive Therapy of Personality Disorders. New York : Guilford Press.

Beck, Aaron T. and Freeman, Arthur M. and Associates (2003). Cognitive Therapy of Personality Disorders, 2nd ed. New York : Guilford Press.

Cooper, Terry D. (2003). Sin, Pride, and Self-Acceptance: The Problem of Identity in Theology and Psychology. Downers Grove, IL: InterVarsity Press.

Gunderson, John G. and Philips, Katherine A. (1995). Personality Disorders. Comprehensive Textbook of Psychiatry/VI, Vol. 2. Eds. Harold I. Kaplan and Benjamin J. Sadock. Baltimore: Williams & Wilkins.

McCrae, Robert R. (1994). "A Reformulation of Axis II: Personality and Personality-Related Problems." Costa, Paul T., Jr., Widiger, Thomas A., editors. Personality Disorders and the Five-Factor Model of Personality. Washington, D.C.: The American Psychological Association.

Oldham, John M., and Lois B. Morris (1995). The New Personality Self-Portrait: Why You Think, Work, Love, and Act the Way You Do. Rev. ed. New York: Bantam.

Stone, Michael H. (1989). Personality Disorders: Schizotypal Personality Disorder. Treatments of Psychiatric Disorders, Vol. 3. American Psychiatric Association. Task Force on Treatments of Psychiatric Disorders. Washington, DC : American Psychiatric Association.

Stone, Michael H. (1993). Abnormalities of personality: within and beyond the realm of treatment. New York: W.W. Norton.

Tamney, Joseph B. (2002). The Resilience of Conservative Religion. New York: Cambridge UP.

---

Schizoid Personality Disorder


Neurotic Solution: Schizoid Type
Solitary Personality Type
Values of the Solitary Type New!



Perspectives q.v.

* Disease
* Dimensional
* Behavior
* Life Story



The Disease Perspective

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (American Psychiatric Association, 1994, pg. 641) describes Schizoid Personality Disorder as a pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

* neither desires nor enjoys close relationships, including being part of a family;

* almost always chooses solitary activities;

* has little, if any, interest in having sexual experiences with another person;

* takes pleasure in few, if any, activities;

* lacks close friends or confidants other than first-degree relatives;

* appears indifferent to the praise or criticism of others;

* shows emotional coldness, detachment, or flattened affectivity.





The Dimensional Perspective



Dimensions

Here is a hypothetical profile, in terms of the five-factor model of personality, for Schizoid Personality Disorder (speculatively constructed from McCrae, 1994, pg. 306):


High Neuroticism
Chronic negative affects, including anxiety, fearfulness, tension, irritability, anger, dejection, hopelessness, guilt, shame; difficulty in inhibiting impulses: for example, to eat, drink, or spend money; irrational beliefs: for example, unrealistic expectations, perfectionistic demands on self, unwarranted pessimism; unfounded somatic concerns; helplessness and dependence on others for emotional support and decision making.

Low Extraversion
Social isolation, interpersonal detachment, and lack of support networks; flattened affect; lack of joy and zest for life; reluctance to assert self or assume leadership roles, even when qualified; social inhibition and shyness.

High Openness
Preoccupation with fantasy and daydreaming; lack of practicality; eccentric thinking (e.g., belief in ghosts, reincarnation, UFOs); diffuse identity and changing goals: for example, joining religious cult; susceptibility to nightmares and states of altered consciousness; social rebelliousness and nonconformity that can interfere with social or vocational advancement.

Low Agreeableness
Cynicism and paranoid thinking; inability to trust even friends or family; quarrelsomeness; too ready to pick fights; exploitive and manipulative; lying; rude and inconsiderate manner alienates friends, limits social support; lack of respect for social conventions can lead to troubles with the law; inflated and grandiose sense of self; arrogance.

Low Conscientiousness
Underachievement: not fulfilling intellectual or artistic potential; poor academic performance relative to ability; disregard of rules and responsibilities can lead to trouble with the law; unable to discipline self (e.g., stick to diet, exercise plan) even when required for medical reasons; personal and occupational aimlessness.



Specific Affects

Emotional coolness or aloofness (absence of warm, tender feelings for others), constricted affect, indifference to praise or criticism or to the feelings of others, anhedonia, shyness, distrust, introversion, discomfort with intimacy, loneliness, anxieties concerning the mother-child symbiosis and other close relationships, feelings of utter unworthiness--but also of superiority, self-consciousness and feeling ill at ease with people, oversensitivity, destructive feelings, painful feelings, overwhelming anxiety (or even psychosis), emotional distance, intense loneliness, inordinate guilt over masturbation, fear of going crazy, sensitivity to slights (Stone, pp. 2712-2717).

Anhedonia, aversiveness, or introversion; social anxiety; depression (Gunderson & Philips, pg. 1445).



Character Weaknesses and Vices*

* prefers to be alone
* prefers solitary activities
* emotionally constricted
* indifferent to sex
* no close friends*
* aloof
* indifferent to opinion


Know Your Major Weaknesses


* Derived from Michael Stone's (pg. 22) list of the "personality traits" of DSM-III-R Schizoid Personality Disorder. Descriptors marked with an asterisk, he says, are not true personality traits.


The Behavior Perspective

Motivations

Want to avoid interpersonal relationships because others are intrusive and unrewarding (Beck & Freeman, pg. 120).

Behaviors

Detachment from social relationships, avoidance of opportunities for intimacy and close relationships, spending most of their time alone, almost always choosing solitary activities or hobbies, prefering mechanical or abstract tasks, showing little interest in having sexual experiences with another person, maintaining an indifference to the approval and criticism or others, not responding appropriately to social cues.

Difficulty expressing anger, lack of direction and goals, reacting passively to adverse circumstances, difficulty responding appropriately to important life events, lack of social skills, lack of desire for sexual experiences, forming few friendships, dating infrequently, often not marrying, occupational functioning often impaired (American Psychiatric Association, pp. 694-695).

Associated Disorders

Brief psychotic episodes, Delusional Disorder, Major Depressive Disorder, Schizophrenia (American Psychiatric Association, pg. 695).

Dysthymic Disorder, Social Phobia, Agoraphobia (Gunderson & Philips, pg. 1445).



* Google Search: schizoid behavior.therapy
* Google Search: comorbidity schizoid personality



The Life Story Perspective

Childhood

"Retrospective assessment suggests that patients with schizoid personality disorder often have histories of grossly inadequate, cold, or neglectful early parenting, which often began early in life. Psychodynamic theories suggest that these traumatic experiences create an expectation that relationships will not be gratifying and a subsequent defensive withdrawal from others" (Gunderson & Philips, pg. 1445).

"A child born with an introverted, shy temperament may be constitutionally predisposed to developing this disorder, especially if the earliest parenting is cold, neglectful, insensitive, or hostile to the infant's disposition. Some psychodynamic theorists believe that individuals with this disorder remain completely unattached to people because they gave up early on any hope of gratification from others. Following their inborn temperamental style, perhaps they adapted to their unsatisfying environment by turning inward, away from any attachment to anyone" (Oldham, pp. 291-92).

Intrusive mothering, detached fathering.



Universal Character Disorder Passive-Aggressive


Stoic explanation

Schizoid personality disorder is a typological representation of bad character, of a vicious disposition formed by habitual passion. Passions are, or are the results of, erroneous value-judgments. The objects of passion listed below (derived mostly from Beck, Freeman, and associates, 1990, pp. 51-2) are external, indifferent things that the Schizoid personality incorrectly judges to be good or bad. (Evolutionary Psychology and Behavior Genetics provide adequate scientific explanations of the origins of these impulses.) The cure of Schizoid personality disorder will require correcting these habitual, erroneous value-judgments by making proper use of impressions.


Niebuhrian / Horneyan explanation

Schizoid character disorder is a type of "solution" to the problem of anxiety ; that is, it is a strategy to alleviate anxiety. The objects of desire and pleasure listed below (derived mostly from Beck, Freeman, and associates, 1990, pp. 51-52) are limited goods pridefully turned to for security when we fail to trust God. They are analogous to Karen Horney's "neurotic needs."

Karen Horney: Intrapsychic Strategies of Defense

The Resignation Solution

"Even when we deeply value ourselves, the anxiety built into finitude will tempt us to find our source of security in some strategy rather than a trust in God" (Cooper, pg. 163).


Habitual Passions

Desires/ Pleasures

Fears/ Distresses

* solitude
* isolation
* autonomy
* detachment
* being alone
* mobility
* independence
* solitary pursuits
* making decisions by oneself
* carrying out solo activities
* not getting involved
* freedom of action
* keeping one's distance
* sexual pleasure
* knowledge
* competency
* privacy
* leisure



* intimacy
* being involved in a group
* other people (because they are intrusive)
* closeness
* close relationships
* being encumbered by other people
* being encumbered by employment
* actions by others that represent encroachment
* close encounters
* having to share decision making
* showing feelings
* sexual experiences with others
* social responsibilities



Cognitive Effects

Basic Belief: I need plenty of space. [Strategy]: Isolation (Beck, Freeman & associates, pg. 26).

The "idealized self is made up of beliefs about how we should feel, think, or act" (Tamney, pg. 32).

Compulsive beliefs and attitudes are idols, too.

In Cognitive Therapy of Personality Disorders, Aaron T. Beck, Arthur Freeman, and associates (1990) list typical beliefs associated with each specific personality disorder. According to my view, the beliefs and attitudes rationalize and reinforce the idealized image and the compulsive attachments and aversions. They are analogous to Karen Horney's "shoulds" and "neurotic claims." Here are the typical beliefs that they have listed (pg. 362) for Schizoid Personality Disorder:

* It doesn't matter what other people think of me.
* It is important for me to be free and independent of others.
* I enjoy doing things more by myself than with other people.
* In many situations, I am better off to be left alone.
* I am not influenced by others in what I decide to do.
* Intimate relations with other people are not important to me.
* I set my own standards and goals for myself.
* My privacy is much more important to me than closeness to people.
* What other people think doesn't matter to me.
* I can manage things on my own without anybody's help.
* It's better to be alone than to feel "stuck" with other people.
* I shouldn't confide in others.
* I can use other people for my own purposes as long as I don't get involved.
* Relationships are messy and interfere with freedom (362).
* Relationships are problematic.
* Life is less complicated without other people.
* I am empty inside.
* It is better for me to keep my distance and maintain a low profile.
* I am a social misfit.
* Life is bland and unfulfilling.



Beck's Cognitive Therapy for Personality Disorders



* Google Search: schizoid cognitive.therapy
* Google Search: schizoid cognitive.behavioral.therapy
* Google Search: schizoid psychoanalytic therapy
* Google Search: schizoid psychodynamic therapy
* Google Search: schizoid interpersonal therapy
* Google Search: schizoid humanistic therapy
* Google Search: schizoid existential therapy



American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. 4th ed. Washington: Author.

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. 4th ed., text revision. Washington: Author.

Beck, Aaron T. and Freeman, Arthur M. and Associates (1990). Cognitive Therapy of Personality Disorders. New York : Guilford Press.

Beck, Aaron T. and Freeman, Arthur M. and Associates (2003). Cognitive Therapy of Personality Disorders, 2nd ed. New York : Guilford Press.

Cooper, Terry D. (2003). Sin, Pride, and Self-Acceptance: The Problem of Identity in Theology and Psychology. Downers Grove, IL: InterVarsity Press.

Gunderson, John G. and Philips, Katherine A. (1995). Personality Disorders. Comprehensive Textbook of Psychiatry/VI, Vol. 2. Eds. Harold I. Kaplan and Benjamin J. Sadock. Baltimore: Williams & Wilkins.

McCrae, Robert R. (1994). "A Reformulation of Axis II: Personality and Personality-Related Problems." Costa, Paul T., Jr., Widiger, Thomas A., editors. Personality Disorders and the Five-Factor Model of Personality. Washington, D.C.: The American Psychological Association.

Stone, Michael H. (1989). Personality Disorders: Schizoid Personality Disorder. Treatments of Psychiatric Disorders, Vol. 3. American Psychiatric Association. Task Force on Treatments of Psychiatric Disorders. Washington, DC : American Psychiatric Association.

Stone, Michael H. (1993). Abnormalities of personality: within and beyond the realm of treatment. New York: W.W. Norton.

Tamney, Joseph B. (2002). The Resilience of Conservative Religion. New York: Cambridge UP.



A Comprehensive Phenomenological Profile - Salman Akhtar, M.D.

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Is that really me? No it can´t be.. And yet it is. Well we all did know that, so it´s really nothing. So... I´ll go and get a cup of coffee... And write some shit.