الفهرس 
INTRODUCTION AND AIM OF THE WORKOnly 14 pages are availabe for public view
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Abstract
Aim of the work:
The aim of this work is to review Schizoid Personality Disorder regarding (and including):
1- General background about Schizoid Personality Disorder.
2- Psychopathology of Schizoid Personality Disorder according to different psychopathological models with special emphasis on the object relational point of view.
3- Psychotherapy of Schizoid Personality Disorder including both individual as well as group psychotherapeutic interventions.
4- Linking theoretical background of Schizoid Personality Disorder involving psychopathology and psychotherapy to our clinical experience especially in group psychotherapy.
SUMMARY
The schizoid personality disorder is a pervasive pattern of social detachment and restricted emotional expression. Introversion (versus extraversion) is one of the fundamental dimensions of general personality functioning. Facets of introversion include low warmth (e.g., cold, detached, impersonal), low gregariousness (socially isolated, withdrawn) and low positive emotions (reserved, constricted or flat affect, anhedonic), which define well the central symptoms of Schizoid Personality Disorder.
Approximately half of the general population will exhibit an introversion within the normal range of functioning. However, only a small minority of the population would be diagnosed with a schizoid personality disorder. Estimates of the prevalence of Schizoid Personality Disorder within the general population have been less than 1% and Schizoid Personality Disorder is among the least frequently diagnosed personality disorders within clinical settings.
Individuals with schizoid personality disorder are viewed as dull, uninteresting, and humorless; they are often ignored. While their speech is laconic and meager, what they say is rarely abnormal. They appear to be indifferent, aloof, and unresponsive to praise, criticism, or feelings expressed by others.
Schizoid Personality Disorder can be confused with the schizotypal and avoidant personality disorders as all involve social isolation and withdrawal. Schizotypal personality disorder, however, also includes an intense social anxiety and cognitive–perceptual aberrations. The major distinction with avoidant personality disorder is the absence of an intense desire for intimate social relationships. Avoidant persons will also exhibit substantial insecurity and inhibition, whereas the schizoid person is largely indifferent toward the reactions or opinions of others.
Reviewing the literature on psychopathology of schizoid personality disorder, it has been found that the object relation theorists had the greatest interest in approaching the schizoid dilemma.
Regarding the views of Melani Klein, she thought that the violent splitting of the self and excessive projection as well as narcissistic nature which derives from the infantile introjective and projective processes may lead to a compulsive tie to certain objects or—another outcome—to a shrinking from people in order to prevent both a destructive intrusion into them and the danger of retaliation by them. The fear of such dangers may show itself in various negative attitudes in object relations.
Fairbairn had a broader view when he widened the term “Schizoid personality” to cover many states, states characterized by the attitude of absolute power, of detachment, the interest carried to internal reality. These states testify to a difficulty of integrating certain parts of the personality, parts which remain cleaved.
Guntrip viewed the dilemma that the well-mothered infant ’develops a growing sense of his own ego-wholeness and ego-identity, as a part of his over-all experience of being in a reliable, secure, supportive relation to his mother’ and so ’he feels a profound sense of belonging and of being at one with his world which is … the persisting atmosphere of security in which he exists within himself’. Where mothering is inadequate or positively bad, a potentially pathogenic condition of insecurity is created.
The views of Erikson, Mahler and Jacobson on the development of a separate sense of self and identity have a significant, though somewhat indirect, bearing upon understanding the phenomenology of schizoid personality. According to these views, schizoid personality belongs to a group of character disorders that show an incompletely developed sense of self, poorly consolidated identity, continued presence of unsynthesized contradictory identifications, and a persisting dependence upon external objects for cohesiveness of the self-experience.
Kohut viewed that if schizoid personality was a defensive organization- It resulted from the individual’s “preconscious awareness not only of his narcissistic vulnerability, but also, and specifically, the danger that a narcissistic injury could initiate an uncontrollable regression”.
While Fairbairn, Guntrip and Klein talk about early persecutory or rejecting objects, Bucci sees early emotional development in terms of the formation of pathological or healthy schemas. Healthy memory schemas are continually open to change. When these schemas — either because of overwhelming experiences in the past or present — are closed off, the results are defensive dissociation “desymbolizing” and dysfunctional attempts to repair a process that brings its own difficulties.
Regardless of the dilemma of defining the word difficult, a schizoid patient is a therapeutic challenge. Silence in the group and help rejecting complaining are the most frequent presentation of the schizoid patient. The schizoid patient comes into treatment motivated by the inexorable push of the need for attachment. At the same time, the patient is convinced that the therapist, like most significant people in the patient’s past, will attempt to reenact the conditions found in the master/slave unit or in the sadistic object/self-in-exile unit’. And, again, the unique intrapsychic structure informs as to the treatment of choice. Because of the operation of the ’master-slave’ object relations unit, the schizoid individual is likely to experience confrontations as coercive and controlling, in resonance with the projection of the ’master’ object.
Psychodynamically, therapeutic goals with the Schizoid Personality Disorder patient will begin with careful, explicit considerations of trust and asking for, receiving, and giving permission. Affective objectives will be to increase the Schizoid Personality patient’s tolerance for feeling and expression. Some therapists might try to open primal feelings of rage and terror buried at the core of the Schizoid Personality.
Yalom emphasizes that this will be a slow work and that patience is essential for the therapist. The primary aim of work with the schizoid person is to encourage him or her to address the tasks of living, It is believed that the best way to do this is encouragement, by aiding the Schizoid Personality Disorder to take heart in living. The therapist must find ways to notice and to support any success the schizoid person has. To do so, we must have much heart and courage ourselves. Schizoid Personality Disorder is untreatable only when we cannot find a way to do so.
A case example was introduced as a presentation of psychopathology of Schizoid Personality Disorder and suitability and effect of both dyadic and group psychotherapy. Enlightened with this case example, it has been clear that psychotherapy with its various modalities, especially dynamic interactive group psychotherapy, is a powerful intervention in treating Schizoid Personality Disorder patients.