Personality Disorder Concepts: Defining Characteristics

These are the defining characteristics of PDs, each of which are different depending on the PD in question.

Triggering event(s).

The situations that triggeramaladaptive response that is reflected in the person’s behavioral, interpersonal, cognitive, and affective styles. Triggering events can be intrapersonal (e.g. failing an exam), or interpersonal (e.g. being criticised).

• ASPD: Social standardsandrules.
• AVPD:Close relationships; being social/in public.
• BPD: The expectationofmeeting goals; maintaining close relationships; real or imagined abandonment.
• DPD: The expectationthat they can rely on themselves; being alone.
• HPD:Relationships, particularly with those they’re attracted to.
• NPD:Self-evaluation, either by themselvesorothers.
• OCPD:Unstructured situations; meeting other’s standards(in all aspects of life: work, family, etc).
• PPD:Close relationships; personal questions.
• STPD:Close relationships.
• SZPD:Close relationships.

Behavioral style

The way in which the person reactsto a triggering event.

• ASPD: Impulsive, irritable, aggressive; irresponsibleandstruggles to keep commitments; relies on themselves, uses cunningand force; risk-taking and thrill-seeking.
• AVPD:Tenseandself-conscious; controlled speech & behaviour; appear apprehensiveand awkward; self-criticising and overly humble.
• BPD:Self-damaging behaviours (self-harm, self-sabotage, suicidal ideation); aggression;achieve less than they could (e.g. in work or school); chronic insomnia& irregular circadian rhythms (”body clocks”); feel helpless&emptyvoid.
• DPD:Docile,passive,non-assertive, insecure, and submissive; doubts themselves & lacks self-confidence.
• HPD:Charming, dramatic, expressive; demanding, self-indulgent, inconsiderate; attention-seeking, mood swings, impulsive, unpredictable, and superficial.
• NPD:Self-centred, egotistical, self-assured; dominates conversations; seeks approval and attention; impatient, arrogant, hypersensitive.
• OCPD:Perfectionists; workaholics; dependable, stubborn, possessive; indecisive, prone to procrastination.
• PPD: Always tenseandhypervigilant;defensive, argumentative, guarded.
• STPD:Eccentric, bizarre; strange speech;struggles with work and school and often become driftersand wanderers; avoids long-term commitment and looses touch with society’s expectations; dissociative.
• SZPD:Lethargic, inattentive, eccentric; slow and monotone speech; rarely spontaneous; indifferent.

Interpersonal style

The way they relate to others.

• ASPD:Deceitful;irritable, antagonistic and aggressive; disregards their and other’s safety; distrustful; lacks empathy; competitive.
• AVPD: Sensitive to rejection; want acceptancebut are too scared; withdraw and avoid when afraid; test people to see if they’re safe to interact with.
• BPD: “Paradoxical instability”;splitting(idealise& cling vs devalue& dismiss); sensitive to rejection; “abandonment depression” & separation anxiety; superficial yet quickly developed and intense relationships; “extraordinarily intolerant” of being alone.
• DPD:People-pleasers, self-sacrificing, clingy & needs reassurance; over-compliant & over-reliant on others; want others to be in control of their lives; avoids arguments; puts themselves down so they can receive the support of others; urgently seeks a new relationship when one ends.
• HPD:Needs attention; flirtatious, manipulative; lacks empathy; overestimates intimacy of relationships.
• NPD:Exploitative; self-indulgent; charming, pleasant & endearing;lacks empathy; irresponsible; jealous; needs approval and admiration.
• OCPD:Very aware of social hierarchy;deferentialto superiors and haughtyto subordinates; polite and loyal; insist that their way is the right way to do things, because they are anxious to ensure perfection; stubborn; devoted to work which interferes with relationships.
• PPD:Distrustful, secretive, suspicious, tend to isolate themselvesandavoid intimacy;hypersensitiveto criticism; bears grudges and blames others; reluctant to open up for fear of vulnerability.
• STPD:Loners; socially anxious, apprehensive, suspicious and paranoid, which doesn’t fade as they get to know people; tends to live on the margins of society and relationships; often choose jobs with minimal social interaction that are usually below their skill level; indifferent to social norms.
• SZPD:Aloof, loners, reserved, solitary; socially awkward; tend to fade into the background; happy to remain alone.

Cognitive style

How the person perceivesandthinksabout a problem and its solution.

• ASPD: Impulsive; realistic; very aware of social cues; prone to executive dysfunction.
• AVPD:Hypervigilant; distracted and preoccupied with their fears of rejection.
• BPD: Inflexible (splitting) & impulsive; difficulty learning from the past; external loss of control leads them to blame others to avoid feeling powerless;emotions fluctuate between hope and despair; unstable self-image andfragmented sense of self; unable to tolerate frustration; brief psychotic episodes;dissociation; intense rage; difficulty focusing & processing information.
• DPD:Suggestibleand persuadable; optimistic, sometimes to the point of naïveté; uncritical; minimises difficulties and are easily taken advantage of.
• HPD:Impulsive, dramatic; vague; suggestible; relies on intuition; avoids reflection and introspection as so to avoid realising their dependency on others; needs approval from others; has separate real/inner/private &constructed/outer/publicselves; tendency to mimicspeech patterns.
• NPD: Focuses on feelingsrather than facts; compulsive lying (to themselves as well as others); inflexible, impatient, persistent;superiority;unrealistic goals of success, power, ideal love.
• OCPD:Rule & detail oriented; difficulty with prioritising; inflexible, unimaginative; conflictedbetweenassertiveness & defiance vs obedience & pleasing people.
• PPD:Mistrustful;hypervigilant; focuses on feelings (of paranoia) rather than facts; brief psychotic episodes; their need to find evidence for their paranoid suspicions gives them a tendency for authoritarianism.
• STPD:Scattered; obsessive and tends to ruminate;superstitious, bizarre fantasies; vague ideas of reference (thinking things are about them when they’re not, e.g. someone laughing is directed at them) and magical thinking (thinking they caused something to happen by thinking about it); dissociative.
• SZPD:Distracted; difficulty organising their thoughts;vagueandindecisive; difficulty with introspectionandreflection.

Affective style

How the person expressesandexperiences emotions.

• ASPD:Superficially expresses emotions; avoids emotions that will make them vulnerable;rarely feels guilt, shame or remorse; unable to tolerate boredom,depression, & frustrationandneeds stimulation.
• AVPD:Shy & apprehensive; feels empty, sad, lonely & tense;depersonalisation.
• BPD:Mood swings; inappropriately intense anger; feelings of emptiness, boredom, a “void”; emotional dysregulation.
• DPD:Insecure & anxious;lacks self-confidence & fears being alone; fears abandonment & rejection; often sad or somber.
• HPD: Displays intense, extreme emotions but may only feel them shallowly; sensitive to rejection; mood swings;need reassurance that they are loved.
• NPD: Presents as self-confidentandnonchalant; when criticised or rejected (”narcissistic injury”) they experience extreme shame which is often redirected into anger (”narc rage”/shame redirect); splitting;lacks empathy and so has difficulty with commitments.
• OCPD: Somber, difficulty expressing feelings; avoids emotions that will make them vulnerable; comes across as stiffand stilted.
• PPD: Cold, aloof, humourless; difficulty expressing feelings; tendency for angerandjealousy.
• STPD: Cold, humourless, aloof; difficult to engage with;suspicious and mistrustful; hypersensitive; may react inappropriately for the situation or not at all.
• SZPD: Humourless, cold, aloof; indifferent; lacks empathy; emotionally and socially distant;difficulty responding to other people’s feelings.

Temperament

Theresponse pattern that reflects the person’s energy level, emotions andintensity of emotions, and how quickthey react.

• ASPD:Irresponsible, aggressive andimpulsive.
• AVPD:Irritable.
• BPD:Passive(dependent subtype); hyperreactive(histrionic subtype); irritable(passive-aggressive subtype).
• DPD:Low energy; fearful, sad or withdrawn; melancholic.
• HPD:Hyperresponsive;needs attention from others.
• NPD:Activeandresponsive; has special talents and developed language early.
• OCPD:Irritable, difficult, anxious.
• PPD:Activeandhyperresponsive(narcissistic subtype); irritable (obsessive-compulsive and passive-aggressive subtypes).
• STPD:Passive(schizoid subtype); fearful(avoidant subtype).
• SZPD:Passive, difficulty experiencing pleasureandmotivation(anhedonia).

Attachment style

Discussed in this post.

• ASPD:Fearful-dismissing.
• AVPD:Preoccupied-fearful.
• BPD:Disorganised.
• DPD:Preoccupied.
• HPD:Preoccupied.
• NPD:Fearful-dismissing.
• OCPD:Preoccupied.
• PPD:Fearful.
• STPD:Fearful-dismissing.
• SZPD:Dismissing.

Parental injunction

Theexpectation(explicit or implied) from caregivers for how the child should be oract.

• ASPD: “The end justifies the means.”
• AVPD: “We don’t accept you, and probably nobody else will either.”
• BPD: “If you grow up,bad things will happen to me [caregiver].”; overprotective,demandingorinconsistentparenting.
• DPD: “You can’t do it by yourself.”
• HPD: “I’ll give you attention when you do what I want.”
• NPD: “Grow up and be wonderful, for me.”
• OCPD: “You must do/be better to be worthwhile.”
• PPD: “You’re different.Keep alert.Don’t make mistakes.”
• STPD: “You’re a strange bird.”
• SZPD: “Who are you, what do you want?”

Self view

The way they viewandconceptualise themselves.

• ASPD:Cunning&entitled.
• AVPD:Inadequate&frightened of rejection.
• BPD:Identity problems involving gender, career, loyalties, and values; self-esteem fluctuates with emotions.
• DPD:Pleasantbut inadequate, fragile.
• HPD:Needs to be noticed.
• NPD:Special, unique and entitled; relies on others for self-esteem.
• OCPD:Responsiblefor anything that goes wrong, so they must be perfect.
• PPD: They’re alone and disliked because they’re differentand better than others.
• STPD:Differentthan other people.
• SZPD:Differentfrom others; self-sufficient; indifferentto everything.

World view

The way they view the world, others, and life in general.

• ASPD:Life is dangerousandrules get in the way of their needs. They won’t be controlledordegraded.
• AVPD:Life is unfair; even though they want to be accepted, people will reject them, so they’ll be vigilant&demand reassurance; escapes using fantasiesanddaydreams.
• BPD:Splitsbetween people and the world as either all-good or all-bad, resulting in commitment issues.
• DPD: Other people need to take care of thembecausethey are unable to.
• HPD: Life makes them nervous, so they need attention and reassurance that they’re loved.
• NPD: Life is full of opportunities; they expect admiration and respect.
• OCPD: Life is unpredictableandexpects too much, so they manage this by being in control and being perfectionists.
• PPD: Life is unfair, unpredictable, demanding, and dangerous; they need to be suspiciousandon guard against others, who are to blame for failures.
• STPD: Life is strangeandunusual; others have special magic intentions, so they are curiousbut also cautiouswhen interacting with the world.
• SZPD: Life is difficultanddangerous; if they trust no oneandkeep their distance from others, they won’t get hurt.

Maladaptive schema

Discussed in this post.

• ASPD:Mistrust/abuse;entitlement; insufficient self-control;defectiveness;emotional deprivation; abandonment; social isolation.
• AVPD:Defectiveness; social isolation; approval-seeking; self-sacrifice.
• BPD:Abandonment;defectiveness;abuse/mistrust; emotional deprivation; social isolation; insufficientself-control.
• DPD:Defectiveness; self-sacrifice; approval-seeking.
• HPD:Approval-seeking; emotional deprivation; defectiveness.
• NPD:Entitlement; defectiveness; emotional deprivation; insufficientself-control;unrelentingstandards.
• OCPD:Unrelenting standards; punitiveness; emotional inhibition.
• PPD:Abuse/mistrust; defectiveness.
• STPD:Alienation;abandonment; dependence; vulnerability to harm.
• SZPD:Social isolation; emotional deprivation; defectiveness; subjugation; undeveloped self.

Optimal diagnostic criterion

One key criterion for each personality disorder, based on its ability to summarise all criteria for that PD,accurate description of behaviour, and the predictive value (ability to predict if the person has the PD or not).

• ASPD:Aggressive, impulsive, irresponsible behavior.
• AVPD:Avoidsactivities that involve being socialout of fear of criticism, disapproval, or rejection.
• BPD: Frantic efforts to avoid real or imagined abandonment.
• DPD:Needs other people to be responsible for most major parts of their lives.
• HPD:Uncomfortable not being the centre of attention.
• NPD:Grandiose sense of self-importance.
• OCPD: Perfectionism that interferes with life.
• PPD:Paranoia, without evidence, that others are trying to harm, exploit or deceive them.
• STPD:Thinking, speech, behavior, or appearance that is odd, eccentric, or peculiar.
• SZPD: Doesn’t want or enjoy close relationships.

- From Sperry, Handbook of Diagnosis and Treatment of DSM-5 Personality Disorders(2016)

There is a myth that I want to dispel about how schizoids never get lonely. That’s untrue. 

Schizoid Personality Disorder is a name for a collection of defense mechanismssuch as ghosting, oscillating in and out of relationships, withdrawal, isolation, dissociation, emotional shut down, and fantasy. And these defense mechanisms are performed to prevent feeling engulfed by others, create a feeling of safety, and to protect from loneliness (such as the fantasy defense).

Some schizoids can rarely get lonely. Those are ones who have such vivid fantasy lives that it completely replaces real life social interaction and leads to fulfillment. But there are some schizoids where this defense mechanism does not work.

I have a MEGA folder of resources on schizoid personality disorder. Books and lots of research from scientific journals all published by psychologists. 

All of the texts I will be copy and pasting below are from licensed clinical psychologists who have studied this disorder for years, even decades in some cases.

Yontef says:

“To people with schizoid personality organization, real human connections are terrifying. In their fantasy life and their behavior, these individuals try to live as if in a castle on an island where they are totally safe. The main feature of this isolation is a denial of attachment and the need for other people. Of course, living that way brings on another terror – the terror of not being humanly connected.”

Some schizoids go as far as to deny the need for attachment and closeness so they don’t even recognize loneliness when they feel it.

Wheeler says:

“With its one-sided focus on the schizoid’s anhedonia and blunted affect, the descriptive psychology tradition paints the portrait of a person completely unfamiliar with anger, affection, joy, or sadness. Yet, it is not that schizoid personalities are without feelings, but rather that feelings are usually channeled inward and played out within an emotionally charged fantasy life rather than being expressed outwardly. The schizoid is all too familiar with the feeling of overwhelming terror that he will fall apart, become unglued, exposed, or annihilated if his feelings were to surface. He knows what it is to experience intense hopelessness, powerless, and vulnerability interacting with others in the world. Living a life without companions, he often feels needy, deprived, unloved, and lonely. In social situations, unable to make meaningful contact, he feels rejected, unwanted, and even hated.”

Most schizoids, internally, experience the same range of emotions that neurotypicals do. If one claims not to, they are either experiencing alexithymia, don’t want to admit to it for fear of being seen too vulnerable, they aren’t aware of their loneliness, are protecting themselves from loneliness through fantasy, or they are dissociated and detached from their emotions.

Laing says:

“The ‘self-conscious’ person is caught in a dilemma. He may need to be seen and recognized, in order to maintain his sense of realness and identity. Yet, at the same time, the other represents a threat to his identity and reality. One finds extremely subtle efforts expended in order to resolve this dilemma in terms of the secret inner self and the behavioral false-self systems already described. James, for instance, feels that ‘other people provide me with my existence.’ On his own, he feels that he is empty and nobody. 'I can’t feel real unless there is someone there…’ Nevertheless, he cannot feel at ease with another person, because he feels as 'in danger’ with others as by himself.”

Some schizoids, when alone for too long, will experience derealization and depersonalization.

Laing says:

“Other people were necessary for his existence, said James. Another patient, in the same basic dilemma, behaved in the following way: he maintained himself in isolated detachment from the world for months, living alone in a single room, existing frugally on a few savings, daydreaming. But in doing this, he began to feel he was dying inside; he was becoming more and more empty, and observed ‘a progressive impoverishment of my life mode.’ A great deal of his pride and self-esteem was implicated in thus existing on his own, but as his state of depersonalization progressed he would emerge into social life for a brief foray in order to get a 'dose’ of other people, but 'not an overdose.’ He was like an alcoholic who goes on sudden drinking orgies between dry spells, except that in his case his addiction, of which he was as frightened and ashamed as any repentent alcoholic or drug-addict, was to other people. Within a short while, he would come to feel that he was in danger of being caught up or trapped in the circle he had entered and he would withdraw again into his own isolation in a confusion of frightened hopelessness, suspicion, and shame.”

This schizoid spent all day in his fantasy world. That common schizoid defense didn’t end up working so he began feeling like he was dying inside and progressively became more empty.

Doidge says:

“The schizoid person tends to alternate between two painful, complex states. On the one hand ‘there is a consuming need for object dependence but attachment threatens the schizoid with the loss of self.’ Schizoids can function well as long as they can successfully repress intense dependence. To avoid losing himself in relations he protects himself by withdrawal and affective isolation. Without meaningful relationships, with affect shut down, he feels enervated, futile, lifeless. The chronic sense of futility, meaninglessness, and deadness are easily misdiagnosed as dysthymia, depression, or minimized as mere existential anxiety.”

Schizoids when lonely can go through emotional shut down and feel lifeless.

Laing says:

“The author believes that schizoid condition can be considered as an intrapsychic constellation of oversensitivity, paralysis and paradoxical conflicts (for example fear of as well as hunger for affection and intimacy) as a result of social/emotional rejection; neglect; bad influences; traumatic experience; conflicts; envy; shame; self-hate; low self-esteem (because of their failure to successful development, interactions, socialization and loneliness) rather than indifference to social interactions. An endurable combination of deep suffering and social isolation makes the schizoid development more and more persistent and deep-anchored.”

The majority of schizoids do not have true indifference, those are just the lowest functioning ones who have given up on relationships altogether who feel genuinely indifferent.

Guntrip says:

On the one hand, the schizoid chooses to be alone, reveling in self-sufficiency and omnipotence, but remaining deeply lonely and empty. On the other hand, the schizoid may choose to enter relationships but then feels pulled toward symbiosis, engulfment, and servitude to the other.  

Solitude in most schizoids causes loneliness and emptiness.

McWilliams says:

In some schizoid patients, loneliness and longing for friendship or love are conscious motivators for seeking therapy. These patients may be seeking relief from an isolated existence and want specifically to work on their inhibitions to social contact or dating.

Some schizoids get so lonely that therapy is sought specifically for that issue.

Reichmann and Storr say:

While schizoid personalities do not often present with issues related to depression, it should be remembered that schizoid patients are not protected from loneliness, however adept they may be at defending against these feelings. Loneliness is one of the most difficult emotions to talk about with others, and is often accompanied by hopelessness, futility, anxiety, manic states, and existential terror the longer it persists (Fromme Reichmann, 1959). Inescapable seclusion for extended periods of time is likely to lead to restlessness, panic, suggestibility, mental distress, nightmares, and even hallucinations, regardless of the individual’s comfort or preference with reclusive behavior or the quality of their mental health (Storr, 1988).

I’ve been seeing my therapist for two years and I still haven’t admitted to my therapist that I sometimes feel lonely. It was even hard for me to admit to myselfbecause I convinced myself for so long that I didn’t need anyone. 

Here is a case material from Guntrip where his schizoid patient describes how her body feels during withdrawal:

[One patient] said, ‘I feel there’s a gap in the middle of my body. There seems to be nothing between my legs and my arms and head.’ She felt that the vital heart of her was missing and she was unreal, and she commented, ‘It’s not like that dream of the women ignoring the baby. If feels as if there isn’t even anyone there at all to ignore me.’ The earlier dream expressed loneliness, the later sensation of an empty gap in her personality expressed isolation and unreality, the loss of her ego, of her sense of selfhood, in experiencing object-loss through feeling out of touch with me.

Wheeler says:

Withdrawal has a huge effect on a person’s life because of its tendency to create alienation and loneliness, and paralyze interpersonal relations. Withdrawal can be passive aggressive and conceal secret omnipotent efforts at self-control, but more frequently, is an attempt to protect the self or the other from the intensity of feelings. Usually the patient experiences withdrawal passively. It is like the feelings have been suddenly drained from the body, leaving only an empty shell to interact with others.

That’s a description of schizoid withdrawal and the alienation and loneliness it causes.

Laing says:

At the same time, the schizoid unconsciously hates and envies those who have potency, warmth, and abundance in their lives (Laing, 1960), unaware that their disdain, indifference, and disgust for others is a symptom of their own loneliness and lack of meaning.

Schizoids can easily confuse loneliness with indifference. I’ve done this in the past.

Guntrip says:

A second form of resistance in the treatment of schizoid personality is the reluctance to engage with the therapist on an emotional level. The patient is unlikely to acknowledge or express anger, longing, or loneliness, despite overwhelming evidence for these things in his dreams, behavior, and fantasy life.

Here, Guntrip describes how some schizoids are unlikely to even acknowledge the feelings of anger, longing, or loneliness.

Wheeler says:

A considerable reduction in the splitting of the needy parts of the self usually leads to greater awareness of suppressed loneliness and longing for the company of others.

Feelings of loneliness can be suppressed and can come into awareness through therapy or introspection.

Martens says:

Several psychoanalytic theorists have suggested that emotional deprivation plays a critical role in the development of schizoid personality disorder, which is characterized by an inability to form emotional attachments. As a consequence of emotional deprivation and an inability to gain security, a lack of satisfaction in interpersonal relationships, and maladaptive schema’s and associated cognitive behavior can be observed as components in attachment distortion and painful loneliness that are crucial in schizoid development.

Schizoids have been described as feeling painful loneliness due to emotional deprivation, inability to feel safe, and lack of satisfaction in relationships.

These are all quotes from peer-reviewed research studiesandpsychology treatment manuals. There is overwhelming evidence that schizoids do in fact experience loneliness.

falsearistocracy:

Maybe she’s born with it, maybe it’s a personality disorder.