Schizoid Personality Disorder - History

History

The term "schizoid" was coined in 1908 by Eugen Bleuler to designate a human tendency to direct attention toward one's inner life and away from the external world, a concept akin to introversion in that it was not viewed in terms of psychopathology. Bleuler labeled the exaggeration of this tendency the “schizoid personality.”

Studies on the schizoid personality have developed along two distinct paths. The "descriptive psychiatry" tradition focuses on overtly observable, behavioral and describable symptoms and finds its clearest exposition in the DSM-IV revised. The dynamic psychiatry tradition includes the exploration of covert or unconscious motivations and character structure as elaborated by classic psychoanalysis and object-relations theory.

The descriptive tradition began in Ernst Kretschmer's 1925 description of observable schizoid behaviors, which he organized into three groups of characteristics:

1. unsociability, quietness, reservedness, seriousness, eccentricity
2. timidity, shyness with feelings, sensitivity, nervousness, excitability
3. pliability, honesty, indifference, silence, cold emotional attitudes.

These characteristics were the precursors of the DSM-IV division of schizoid character into three distinct personality disorders, though Kretschmer himself did not conceive of separating these behaviors to the point of radical isolation but considered them to be simultaneously present as varying potentials in schizoid individuals. For Kretschmer, the majority of schizoids are not either oversensitive or cold, but they are oversensitive and cold "at the same time" in quite different relative proportions, with a tendency to move along these dimensions from one behavior to the other.

The second path, that of dynamic psychiatry, began in 1924 with observations by Eugen Bleuler, who observed that the schizoid person and schizoid pathology were not things to be set apart. W. R. D. Fairbairn's seminal work on the schizoid personality, from which most of what is known today about schizoid phenomena is derived, was presented in 1940. Here Fairbairn delineated four central schizoid themes: (1) the need to regulate interpersonal distance as a central focus of concern, (2) the ability to mobilize self preservative defenses and self-reliance, (3) a pervasive tension between the anxiety-laden need for attachment and the defensive need for distance that manifests in observable behavior as indifference, and (4) an overvaluation of the inner world at the expense of the outer world. Following Fairbairn, the dynamic psychiatry tradition has continued to produce rich explorations on the schizoid character, most notably from writers Nannarello (1953), Laing (1960), Winnicott (1965), Guntrip (1969), Khan (1974), Akhtar (1987), Seinfeld (1991), Manfield (1992) and Klein (1995).

Psychologist Nancy McWilliams argues that the definition of SPD is flawed due to cultural bias: "One reason schizoid people are pathologized is because they are comparatively rare. People in majorities tend to assume that their own psychology is normative and to equate difference with inferiority."